Persistent disorders of mineral metabolism after one year of kidney transplantation

Gomes, Larissa Krüger; Custódio, Melani Ribeiro; Contieri, Fabiana Loss de Carvalho; Riella, Miguel C.; Nascimento, Marcelo Mazza do

doi:10.5935/0101-2800.20160044

Cited by 6 publications

(5 citation statements)

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“…Los pacientes con menos de 36 meses en hemodiálisis tienden a tener un mejor control del metabolismo óseo y mineral que aquellos pacientes con más de 36 meses en hemodiálisis pre trasplante renal. En el estudio realizado en Brasil, se reconoce que el tiempo en hemodiálisis es un factor determinante e importante para el hiperparatiroidismo persistente, ya que aquellos pacientes sometidos a hemodiálisis por más tiempo están asociados a desarrollar hiperparatiroidismo secundario severo; esto podría explicar un metabolismo óseo y mineral más apropiado en los pacientes de este estudio sometidos a hemodiálisis por menos de 36 meses 16 .…”

Section: Discussionunclassified

Cambios en el metabolismo óseo y mineral en pacientes con Enfermedad Renal Crónica sometidos a trasplante renal en el Hospital General Plaza de la Salud durante el período comprendido entre enero 2010–agosto 2018

Moreno

Yangüela

2022

cysa

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Introducción: las alteraciones del metabolismo óseo-mineral, son una causa importante de morbilidad en los pacientes con trasplante renal, por lo que el manejo de las complicaciones del paciente trasplantado, a largo plazo, deben de ser seguidas. El estudio intenta demostrar cambios en el metabolismo óseo y mineral en pacientes con enfermedad renal crónica sometidos a trasplante renal en el Hospital General Plaza de la Salud durante el período comprendido entre enero 2010 – agosto 2018, Santo Domingo, República Dominicana. Método: estudio observacional, descriptivo, retrospectivo y transversal de 131 trasplantes realizados en el Hospital General Plaza de la Salud, evaluando cambios de calcio (Ca), fósforo (P) y hormona paratiroidea (PTH) antes y tres meses post-trasplante. Resultados: la edad media de los pacientes incluidos fue 43.1 ±13.1 años, 72.51 % pertenecía al sexo masculino, con un tiempo medio en hemodiálisis en meses de 27.0 ± 33.6, 60 % de los trasplantes realizados fueron de donante vivo y un 63 % de los pacientes tenía HTA como comorbilidad. El nivel medio de PTH disminuyó en los primeros 3 meses posteriores al trasplante comparado con el pre-trasplante (779.6 ± 1004.0 vs. 167.9 ± 138.2 pg/ml). El fosfato disminuyó significativamente (4.9 ± 1.6 vs. 3.5 ± 0.8) y el calcio aumentó (9.0 ± 1.2 mg/dl vs. a 9.7± 0.8 mg/dl). Discusión: los cambios generales en los niveles séricos de Ca, P, PTH, BUN y creatinina desde el momento del TR a los 3 meses post TR, fueron todos significativos.

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Section: Discussionunclassified

Cambios en el metabolismo óseo y mineral en pacientes con Enfermedad Renal Crónica sometidos a trasplante renal en el Hospital General Plaza de la Salud durante el período comprendido entre enero 2010–agosto 2018

Moreno

Yangüela

2022

cysa

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“…Metabolic changes in patients on hemodialysis compromise lung function [33][34][35], since CKD selectively affects large nerve fibers such as the phrenic nerve, which innervates the diaphragm [23]. Uremic toxin retention not only overloads the respiratory muscles, but affects chest muscle mechanics, resulting in musculoskeletal disorders, loss of capillary action and a decline in contractile proteins and muscle mass [7,35].…”

Section: Discussionmentioning

confidence: 99%

Effect of parathyroid hormone levels on the functional capacity and pulmonary function of patients on dialysis

2020

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Introduction: Chronic kidney disease is characterized as the gradual loss of kidney function, with patients on dialysis experiencing a decline in functional capacity and pulmonary function. One of the non-traditional risk factors is parathyroid hormone (PTH), which influences metabolism and the status of the disease. Objective: Assess the effect of parathyroid hormone levels on functional capacity and pulmonary function in patients on dialysis. Method: Cross-sectional study with hemodynamically stable dialysis patients of both sexes, aged 18 to 59 years, who did not gain more than 2.5kg between dialysis sessions. Two groups were created according to PTH blood levels: PTH (A), with values outside the normal range, and PTH (C), who exhibited normal levels of the hormone. Pulmonary function (PF) was assessed by spirometry and functional capacity (FC) via the six-minute walk test (6MWT). Results: The PTH A group displayed a negative association between PTH levels and PF, based on the values obtained for the spirometric variables forced expiratory volume in 1 second (FEV1) (r = -0.54) and forced vital capacity (FVC) (r= -0.69). The average distance walked by the PTH (C) group was 343.85 ± 98.14 meters. Conclusion: The results suggest that high PTH levels have a negative effect on the PF of patients on dialysis.

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“…However, these types of abnormalities do not always completely resolve in a significant number of patients, even after several years of restored renal function, and these abnormalities may result in the redevelopment of hyperparathyroidism [30]. PTH, blood calcium and phosphorus concentrations usually increase considerably within the first year following RT, and high levels of PTH are associated with increased graft loss and mortality rates [31]. Moreover, persistent secondary and tertiary hyperparathyroidism following transplantation has been observed in 32.9% of patients [32].…”

Section: Discussionmentioning

confidence: 99%

US-guided microwave ablation for secondary hyperparathyroidism in patients after renal transplantation: a pilot study

et al. 2019

International Journal of Hyperthermia

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Objective: To assess the safety and efficacy of ultrasound-guided microwave ablation (MWA) in the treatment of patients who develop secondary hyperparathyroidism (SHPT) after renal transplantation (RT). Methods: In total, nine patients, each with symptomatic SHPT caused by RT and at least one enlarged parathyroid gland, underwent MWA via hydrodissection. Intact parathyroid hormone (i-PTH), serum calcium, serum phosphorus, creatinine and blood urea nitrogen concentrations, before and after MWA, were assessed and compared. Results: Complete ablation was achieved in all patients for a total of 14 ablated parathyroid glands. The mean follow-up time was 17.2 ± 1.7 months post-operation. The mean maximum diameter of the parathyroid glands was 1.3 ± 0.4 cm (range: 0.4-2.0 cm). The ablation power implemented was 30 W and the mean time for each parathyroid gland to achieve complete ablation was 287.5 ± 83.4 s. The mean i-PTH, serum calcium and phosphorus concentrations at one day post-MWA (69.6 pg/mL, 2.23 ± 0.29 mmol/L, 1.2 2 ± 0.48 mmol/L, respectively) were significantly lower than those before MWA (780.0 pg/mL, 2.62 ± 0.32 mmol/L, 1.39 ± 0.61 mmol/L, respectively; p < .01), whereas the creatinine and blood urea nitrogen concentrations before and after MWA did not differ significantly from each other (p > .05). No significant differences were found between the biomarker concentrations observed at one day post-MWA and at the follow-ups (p > .05). No major operation-related complications occurred. Conclusion: Ultrasound-guided MWA is a safe and effective technique for destroying parathyroid gland tissue in patients who develop SHPT after RT and its clinical effects are long-lasting.

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Persistent disorders of mineral metabolism after one year of kidney transplantation

Abstract: Os resultados sugerem que alterações do metabolismo mineral e a pHPT podem ocorrer após um ano do Tx, principalmente em pacientes com níveis elevados de PTH pré-Tx.

Cited by 6 publications

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Cambios en el metabolismo óseo y mineral en pacientes con Enfermedad Renal Crónica sometidos a trasplante renal en el Hospital General Plaza de la Salud durante el período comprendido entre enero 2010–agosto 2018

Cambios en el metabolismo óseo y mineral en pacientes con Enfermedad Renal Crónica sometidos a trasplante renal en el Hospital General Plaza de la Salud durante el período comprendido entre enero 2010–agosto 2018

Effect of parathyroid hormone levels on the functional capacity and pulmonary function of patients on dialysis

US-guided microwave ablation for secondary hyperparathyroidism in patients after renal transplantation: a pilot study

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