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Pre-Transplant Hyperparathyroidism and Graft or Patient Outcomes After Kidney Transplantation

Authors :
Fernanda Guedes Rodrigues
Willemijn Y. Van Der Plas
Camilo German Sotomayor
Amarens Van Der Vaart
Daan Kremer
Robert A. Pol
Schelto Kruijff
Ita Pfeferman Heilberg
Stephan J. L. Bakker
TransplantLines Investigators
Martin H. De Borst
Source :
Transplant International, Vol 37 (2024)
Publication Year :
2024
Publisher :
Frontiers Media S.A., 2024.

Abstract

The impact of pre-transplant parathyroid hormone (PTH) levels on early or long-term kidney function after kidney transplantation is subject of debate. We assessed whether severe hyperparathyroidism is associated with delayed graft function (DGF), death-censored graft failure (DCGF), or all-cause mortality. In this single-center cohort study, we studied the relationship between PTH and other parameters related to bone and mineral metabolism, including serum alkaline phosphatase (ALP) at time of transplantation with the subsequent risk of DGF, DCGF and all-cause mortality using multivariable logistic and Cox regression analyses. In 1,576 kidney transplant recipients (51.6 ± 14.0 years, 57.3% male), severe hyperparathyroidism characterized by pre-transplant PTH ≥771 pg/mL (>9 times the upper limit) was present in 121 patients. During 5.2 [0.2–30.0] years follow-up, 278 (15.7%) patients developed DGF, 150 (9.9%) DCGF and 432 (28.6%) died. A higher pre-transplant PTH was not associated with DGF (HR 1.06 [0.90–1.25]), DCGF (HR 0.98 [0.87–1.13]), or all-cause mortality (HR 1.02 [0.93–1.11]). Results were consistent in sensitivity analyses. The same applied to other parameters related to bone and mineral metabolism, including ALP. Severe pre-transplant hyperparathyroidism was not associated with an increased risk of DGF, DCGF or all-cause mortality, not supporting the need of correction before kidney transplantation to improve graft or patient survival.

Details

Language :
English
ISSN :
14322277
Volume :
37
Database :
Directory of Open Access Journals
Journal :
Transplant International
Publication Type :
Academic Journal
Accession number :
edsdoj.88624f245bd4ff3a0b00c02fffcd0ad
Document Type :
article
Full Text :
https://doi.org/10.3389/ti.2024.11916