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A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Calcium and phosphate changes after renal transplantation.
Piergiorgio Messa1, Cosimo Cafforio, Carlo Alfieri
1Nephrology, Dialysis and Renal Transplant Unit, Fondazione Ca' Granda IRCCS, Ospedale Maggiore Policlinico, Milan, Italy. pmessa@policlinico.mi.it
Journal of Nephrology
|December 21, 2010
Summary
Kidney transplant recipients often experience hypercalcemia and hypophosphatemia due to persistent secondary hyperparathyroidism. These metabolic disturbances negatively impact graft and patient outcomes, necessitating careful pre-transplant screening and evaluation of new therapeutic options.
Area of Science:
- Nephrology
- Endocrinology
- Transplantation
Background:
- Hypercalcemia affects up to 66% of kidney transplant (KTx) recipients, often linked to persistent secondary hyperparathyroidism.
- Hypophosphatemia is observed in up to 40% of KTx patients, with causes including hyperparathyroidism and FGF-23 elevation.
- Both conditions can lead to serious complications, including nephrocalcinosis, pancreatitis, vascular calcifications, and bone fractures.
Purpose of the Study:
- To review the prevalence and contributing factors of hypercalcemia and hypophosphatemia post-kidney transplant.
- To discuss the negative impacts of these metabolic derangements on graft and patient outcomes.
- To evaluate current and emerging therapeutic strategies for managing these conditions.
Main Methods:
- Literature review of studies on post-kidney transplant mineral and bone disorders.
- Analysis of factors contributing to hypercalcemia and hypophosphatemia.
- Comparison of surgical (parathyroidectomy) and pharmacological (calcimimetics) treatment options.
Main Results:
- Persistent secondary hyperparathyroidism is a key factor in post-KTx hypercalcemia.
- Hypophosphatemia is associated with hyperparathyroidism, FGF-23, and tubular damage.
- Hypercalcemia and hypophosphatemia contribute to significant morbidity, affecting graft survival and patient health.
Conclusions:
- Effective management requires pre-transplant screening and optimized treatment.
- Calcimimetics offer a potential alternative to parathyroidectomy for hypercalcemia management.
- Addressing these metabolic issues is crucial for improving long-term outcomes in kidney transplant recipients.
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