Influence of Pre-renal Transplant Secondary Hyperparathyroidism on Later Evolution After Transplantation

García-Montemayor, V.; Sánchez-Agesta, Marina; Agüera, María Luisa; Calle, None Od. esp. Mario Esteban Calderón; Navarro, María Dolores; Rodríguez, Alberto; Aljama, Pedro

doi:10.1016/j.transproceed.2018.12.012

Cited by 3 publications

(8 citation statements)

References 25 publications

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“…The preexisting mineral imbalances that lead to SHPT are usually normalized within several days to several weeks after KT (7), but changes in serum PTH levels usually take several months to manifest. Recent retrospective studies (10,11) have described the longterm natural history of SHPT after KT. The PTH level dropped significantly during the first 3 months posttransplant and decreased gradually throughout the and it could partially mitigate systemic disorders of mineral and bone metabolism caused by secondary hyperparathyroidism.…”

Section: Natural Course Of Hyperparathyroidism Following Kt and Preva...mentioning

confidence: 99%

“…Studies have noted a significant correlation between PTH and the estimated glomerular filtration rate (eGFR) (12,13). With the restoration of a more normal eGFR, SHPT might resolve in mild cases or remain stable until the end of the first year post-transplant (11,14). Even with adequate allograft function, PHPT is still observed in 30-60% of kidney transplant recipients 1 year after KT and in 20% of patients even at 5 years (4,14,15).…”

Section: Reviewmentioning

confidence: 99%

“…Concomitant hypercalcemia is an indispensable criterion for THPT but not for PHPT. KT itself is just like a screening procedure, eliminating all of the hyperplastic parathyroid tissue that might return with re-established calcium-phosphate homeostasis, leaving only autonomous tissue that does not respond to feedback (11). Different percentages of THPT components remain in PHPT parathyroid glands at different time-points post-transplant (22).…”

Section: Post-kt Phpt and Its Clinical Significancementioning

confidence: 99%

“…PHPT endangers both patient and allograft survival. First, PHPT is also associated with increased mortality, cardiovascular complications, fractures, and decreased quality of life (11). In a multivariate analysis comparing kidney transplant recipients with serum PTH>65 pg/ mL to those with normal or low levels, an increase of 46% for all-cause death was noted (24).…”

Section: Post-kt Phpt and Its Clinical Significancementioning

confidence: 99%

“…However, the altered mineral metabolism and endocrine function associated with pre-KT parathyroidectomy might be more conducive to allograft survival compared to that associated with untreated SHPT. This could explain why pre-KT parathyroidectomy was considered to be superior to post-KT parathyroidectomy in terms of ensuring allograft function according to several comparative studies (11,25,27,28,32,33). First, the degree of metabolic and endocrine disturbances that an allograft is subjected to is more severe in patients not undergoing pre-KT parathyroidectomy than in those undergoing that procedure.…”

Section: 2mentioning

confidence: 99%

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Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Wang

et al. 2022

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Section: Natural Course Of Hyperparathyroidism Following Kt and Preva...mentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Post-kt Phpt and Its Clinical Significancementioning

confidence: 99%

Section: Post-kt Phpt and Its Clinical Significancementioning

confidence: 99%

Section: 2mentioning

confidence: 99%

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Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Wang

et al. 2022

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Hyperparathyreoidism After Kidney Transplantation

Orlić

2024

Med. Flum. (Online)

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Nakon uspješne transplantacije bubrega dolazi do oporavka egzokrine i endokrine funkcije bubrega. Vrijednosti serumske koncentracije kalcija, fosfata, paraireoidnog hormona (PTH), čimbenika rasta fibroblasta 23 i vitamina D se normaliziraju. Zbog toga bi trebale uslijediti pozitivne promjene u koštanom metabolizmu. Kod dijela bolesnika, unatoč uspješnoj transplantaciji, ostaju poremećaji u koštanom metabolizmu. Učestalost hiperparatireoidizma (HPT) nakon prve godine od transplantacije bubrega kreće se od 10 do 50 %. Trajanje dijalize i stupanj hiperplazije paratireoidnih žlijezda čimbenici su rizika za razvoj poslijetransplantacijskog HPT-a. Liječenje poslijetransplantacijskog HPT-a uključuje terapiju vitaminom D, analozima vitamina D, kalcimemeticima i paratireidektomija.

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Systematic Review of the Treatment of Persistent Hyperparathyroidism Following Kidney Transplantation

et al. 2022

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Chronic kidney disease–mineral and bone disorder is one of the complications associated with chronic kidney disease. About 10–50% of patients following kidney transplantation have persistent hyperparathyroidism. Hypercalcaemic hyperparathyroidism has a negative impact on the kidney transplant outcome; therefore, it requires treatment. The data regarding the treatment of persistent hyperparathyroidism provided in scientific publications are divergent and contradictory. Therefore, the aim of our systematic review was to evaluate the efficacy of persistent hyperparathyroidism treatment in patients following kidney transplantation. The Cochrane, PubMed, and Scopus databases were browsed independently by two authors. The search strategy included controlled vocabulary and keywords. The effectiveness of calcitriol, paricalcitol, cinacalcet, and parathyroidectomy was compared and analysed. The mean calcium and parathormone (PTH) concentrations per patient in the group of paricalcitol increased by 1.27% and decreased by 35.14% (n = 248); in the group of cinacalcet decreased by 12.09% and 32.16% (n = 368); and in the group of parathyroidectomy decreased by 19.06% and 86.49% (n = 15) at the end of the study compared to the baseline (n = 244, n = 342 and n = 15), respectively. Paricalcitol, cinacalcet, and parathyroidectomy decreased the intact PTH level. Cinacalcet and parathyroidectomy lowered calcium levels in renal transplant patients with hypercalcaemia. Conversely, paricalcitol increased the serum calcium concentration. Cinacalcet seems to be a good candidate in the treatment of post-transplant hyperparathyroidism.

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Influence of Pre-renal Transplant Secondary Hyperparathyroidism on Later Evolution After Transplantation

Cited by 3 publications

References 25 publications

Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Timing of parathyroidectomy for kidney transplant patients with secondary hyperparathyroidism: A practical overview

Hyperparathyreoidism After Kidney Transplantation

Systematic Review of the Treatment of Persistent Hyperparathyroidism Following Kidney Transplantation

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