Evaluating Hyperparathyroidism in Simultaneous Pancreas-Kidney Transplant Recipients: A Single-Center Experience

Area of Science:

• Nephrology
• Transplantation Immunology
• Endocrinology

Background:

• Cardiovascular disease is a leading cause of mortality in kidney transplant recipients.
• Hyperparathyroidism (HPT) may accelerate cardiovascular disease, especially in patients with renal failure and diabetes.
• Limited data exist on managing tertiary hyperparathyroidism (3HPT) in simultaneous pancreas-kidney (SPK) transplant recipients.

Purpose of the Study:

• To evaluate the impact of HPT on cardiovascular disease, bone health, and graft function in SPK transplant recipients.
• To compare outcomes between SPK patients with resolved HPT and those who developed 3HPT.

Main Methods:

• Retrospective review of 132 SPK transplant recipients at an academic center.
• Categorization of patients into resolved HPT and unresolved HPT (3HPT) groups.
• Bivariate comparisons using independent group t-tests and Fisher's exact tests.

Main Results:

• 58.3% of SPK recipients developed 3HPT.
• Patients with 3HPT showed significantly lower eGFR and higher HbA1c at 3 years post-transplant.
• All patients exhibited worsening large vessel calcifications, with 3HPT associated with peripheral arterial disease.

Conclusions:

• 3HPT in SPK transplant recipients is associated with impaired renal and pancreatic graft function and increased peripheral arterial disease.
• Further prospective studies are required to confirm these findings and establish treatment guidelines for 3HPT.