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Related Concept Videos

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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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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...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage kidney disease (ESKD). At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate...
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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...
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Related Experiment Video

Updated: Jul 25, 2025

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Persistent hyperparathyroidism after preemptive kidney transplantation.

Manabu Okada1, Tetsuhiko Sato2, Yuki Hasegawa3

  • 1Department of Transplant Surgery and Transplant Nephrology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, Aichi, 4668650, Japan. ubanamadako@yahoo.co.jp.

Clinical and Experimental Nephrology
|June 23, 2023
PubMed
Summary

Pretransplant parathyroid hormone (PTH) levels and donor kidney function predict hyperparathyroidism (HPT) after preemptive kidney transplantation (PKT). HPT is linked to poorer graft survival, highlighting the need for careful monitoring post-PKT.

Keywords:
HyperparathyroidismMultivariate analysisPreemptive kidney transplantation

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Area of Science:

  • Nephrology
  • Endocrinology
  • Transplantation Immunology

Background:

  • Long-term dialysis is a known predictor of persistent hyperparathyroidism (HPT) post-kidney transplantation (KTx).
  • The increasing trend of preemptive kidney transplantation (PKT) necessitates understanding HPT incidence, predictors, and outcomes in this specific population.
  • Current knowledge regarding HPT after PKT remains limited.

Purpose of the Study:

  • To identify predictors of HPT one year after PKT.
  • To evaluate the clinical implications of HPT on graft survival following PKT.
  • To elucidate the relationship between pretransplant factors and post-PKT HPT.

Main Methods:

  • Retrospective cohort study of 340 patients undergoing PKT between 2000 and 2016.
  • Exclusion of patients with graft loss within one year post-transplant.
  • Definition of HPT based on intact parathyroid hormone (PTH) levels (>80 pg/mL) or unexplained hypercalcemia; analysis of graft survival as a secondary outcome.

Main Results:

  • Pretransplant PTH levels (OR, 5.480) and donor estimated glomerular filtration rate (OR, 0.978) were independent predictors of HPT post-PKT.
  • 152 patients developed HPT one year after PKT, while 188 remained HPT-free.
  • Death-censored graft survival was significantly lower in the HPT group (90.4%) compared to the HPT-free group (96.4%) at 10 years (P=0.009).

Conclusions:

  • Elevated pretransplant PTH levels and reduced donor kidney function are significant predictors of HPT after PKT.
  • HPT following PKT is associated with diminished graft survival outcomes.
  • These findings underscore the importance of assessing pretransplant PTH and donor kidney function in patients undergoing PKT.