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Related Concept Videos

Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Peritoneal Dialysis III: Nursing Management01:25

Peritoneal Dialysis III: Nursing Management

Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

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Related Experiment Video

Updated: Jul 20, 2026

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
09:02

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

Post-transplant hypophosphatemia: Tertiary 'Hyper-Phosphatoninism'?

I Bhan1, A Shah, J Holmes

  • 1Renal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.

Kidney International
|August 31, 2006
PubMed
Summary

Fibroblast growth factor-23 (FGF-23) is a key driver of hypophosphatemia after kidney transplants, more so than parathyroid hormone (PTH). This study highlights FGF-23

Related Experiment Videos

Last Updated: Jul 20, 2026

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
09:02

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

Published on: July 31, 2016

Area of Science:

  • Nephrology
  • Endocrinology
  • Transplantation Medicine

Background:

  • Hypophosphatemia is a frequent complication post-kidney transplantation.
  • Tertiary hyperparathyroidism is traditionally implicated, but hypophosphatemia can persist independently of parathyroid hormone (PTH) levels.
  • Inappropriately low calcitriol levels post-transplant suggest non-PTH mediated mechanisms.

Purpose of the Study:

  • To investigate the role of fibroblast growth factor-23 (FGF-23) in post-kidney transplant hypophosphatemia.
  • To test the hypothesis that elevated FGF-23 contributes to hypophosphatemia and reduced calcitriol levels.
  • To compare the association of FGF-23 and PTH with phosphate and calcitriol levels.

Main Methods:

  • Prospective, longitudinal study of 27 living donor kidney transplant recipients.
  • Measurement of serum FGF-23, PTH, phosphate, and calcitriol levels pre- and post-transplantation.
  • Analysis of FGF-23 and PTH exposure using area under the curve calculations.

Main Results:

  • Hypophosphatemia (<2.5 mg/dl) occurred in 85% of recipients; severe hypophosphatemia (< or =1.5 mg/dl) in 37%.
  • Elevated FGF-23 levels post-transplant were independently associated with lower serum phosphate, increased urinary phosphate excretion, and lower calcitriol levels.
  • Higher early FGF-23 exposure (area under the curve) was significantly associated with an increased risk of severe hypophosphatemia (RR 5.3, P=0.02), unlike PTH.

Conclusions:

  • Excessive FGF-23 is a significant contributor to hypophosphatemia and altered calcitriol levels in the early post-kidney transplant period.
  • FGF-23 appears to be a stronger predictor of post-transplant hypophosphatemia than PTH.
  • These findings suggest FGF-23 as a potential therapeutic target for managing mineral and bone disorders post-transplantation.