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Hyperparathyroidism after kidney transplantation: a retrospective case controlled study.

J Vlcek1, U Binswanger, G Keusch

  • 1Departement für Innere Medizin, Universitätsspital Zürich, Schweiz.

Klinische Wochenschrift
|September 16, 1991
PubMed
Summary

Hyperparathyroidism affects nearly 6% of kidney transplant recipients, often requiring parathyroidectomy. Cyclosporine A treatment may increase its incidence, with longer pre-transplant dialysis correlating with its development.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Transplantation Surgery

Background:

  • Hyperparathyroidism is a common complication following renal allotransplantation.
  • The incidence and risk factors for developing hyperparathyroidism post-transplant require further investigation.

Purpose of the Study:

  • To investigate the incidence and characteristics of hyperparathyroidism in renal transplant recipients.
  • To identify potential risk factors and clinical features associated with post-transplant hyperparathyroidism.

Main Methods:

  • Retrospective study of 1119 renal transplantations performed since 1972.
  • Analysis of 534 surviving patients with functioning grafts, identifying 32 (5.9%) who developed hyperparathyroidism requiring parathyroidectomy.
  • Comparison of hyperparathyroid patients with a matched control group.

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Main Results:

  • Hyperparathyroidism developed in 5.9% of renal transplant recipients.
  • The frequency of parathyroidectomy increased after the introduction of cyclosporine A.
  • Patients with hyperparathyroidism had longer pre-transplant dialysis durations and distinct pre-operative serum chemistry (higher calcium and alkaline phosphatase).
  • No significant influence of phosphate binders, calcium, or vitamin D on parathyroid gland hyperactivity during dialysis was observed.

Conclusions:

  • Hyperparathyroidism is a significant complication in renal transplant recipients, with potential links to cyclosporine A and prolonged pre-transplant dialysis.
  • Parathyroidectomy is an effective treatment, though some patients may require long-term calcium supplementation post-surgery.
  • Serum calcium and alkaline phosphatase levels are key indicators for diagnosing hyperparathyroidism in this population.