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Effect of parathyroidectomy on renal graft function
A Garcia1, A Mazuecos, T Garcia
1Department of Nephrology, Hospital Puerta del Mar, Cadiz, Spain. auxmazuecos@terra.es
Transplantation Proceedings
|May 4, 2005
Summary
Parathyroidectomy (PTx) in kidney transplant recipients can cause acute kidney function decline, especially in those with pre-existing renal impairment. Performing PTx before transplantation may be safer for these patients.
Area of Science:
- Nephrology
- Endocrinology
- Transplant Surgery
Background:
- Parathyroidectomy (PTx) is sometimes performed in renal transplant recipients.
- Acute impairment of renal transplant function post-PTx has been reported.
- Severe hyperparathyroidism may not resolve spontaneously after kidney transplantation.
Purpose of the Study:
- To analyze the impact of PTx on renal transplant function.
- To identify factors associated with renal function deterioration after PTx.
- To evaluate the optimal timing for PTx in renal transplant candidates.
Main Methods:
- Retrospective analysis of 22 renal transplant recipients undergoing PTx.
- Monitoring of serum creatinine, parathyroid hormone, calcium, phosphate, and other parameters pre- and post-PTx.
- Comparison of patients with significant SCr increase (>30%) versus those without.
Main Results:
- Acute renal function deterioration observed until the third post-PTx month, with SCr returning to baseline in most patients.
- Patients with greater SCr increase post-PTx had higher pre-PTx SCr levels.
- No significant changes in blood pressure, but a trend towards reduced antihypertensive drug dosage.
Conclusions:
- PTx can lead to acute, temporary renal function impairment in kidney transplant recipients.
- Pre-existing renal dysfunction is a risk factor for worse post-PTx renal outcomes.
- Consideration should be given to performing PTx before kidney transplantation in patients with severe hyperparathyroidism.