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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Hypocalcemia immediately after renal transplantation.
Hironobu Nobata1, Yoshihiro Tominaga, Hirokazu Imai
1Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
Clinical Transplantation
|September 17, 2013
Summary
Immediately after kidney transplants, patients experience a temporary drop in serum calcium levels and increased urinary calcium excretion. Glucocorticoids may contribute to this transient hypocalcemia and calcium wasting post-transplant.
Area of Science:
- Nephrology
- Transplantation Immunology
- Endocrinology
Background:
- Post-renal transplantation (RTX), hypercalcemia and hypophosphatemia are typically expected.
- A transient reduction in serum calcium (Ca) levels immediately after RTX has been observed but not fully explained.
Purpose of the Study:
- To investigate the causes of transient hypocalcemia and altered mineral metabolism immediately following RTX.
Main Methods:
- Serum Ca, phosphorus, intact parathyroid hormone (iPTH), 1,25-dihydroxyvitamin D, and tacrolimus levels were measured in 21 RTX recipients.
- Urinary Ca and phosphorus excretion were assessed within three weeks post-RTX.
- Patients received a three-drug immunosuppressive regimen including glucocorticoids.
Main Results:
- Serum Ca levels significantly declined during the first week after RTX.
- Urinary Ca excretion increased transiently immediately post-RTX, then normalized.
- Increased urinary Ca excretion did not correlate with serum iPTH or tacrolimus levels.
Conclusions:
- Transient hypocalcemia and increased urinary Ca excretion occur immediately after RTX, independent of iPTH and tacrolimus levels.
- Glucocorticoid administration is a potential factor contributing to inappropriate urinary Ca wasting post-RTX.
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