[Plasma parathyroid hormone after kidney transplantation. A sensitive parameter for the estimation of graft function...

Patients after kidney transplantation were investigated for parameters for kidney function and calcium metabolism including a definitively characterized parathyroid hormone (PTH) radioimmunoassay, of which quality criteria have been documented. In 72 transplanted patients 3 months to 7 years after operation a close correlation between graft function and plasma PTH concentrations was found. Patients with clearly elevated PTH revealed definitively decreased graft function. Three patients with normal GFR and clearly elevated PTH showed - at least transiently - all criteria of an autonomous hyperparathyroidism including hypercalcaemia and hypophosphataemia. Borderline PTH elevations associated with normal GFR can be explained by corticosteroid treatment. In 100 patients, which were investigated before and during the first 10 days after transplantation, again a close correlation was documented between the development of PTH concentrations and the function of the transplanted kidney. PTH concentrations are not only a very sensitive parameter of graft function; in various situations plasma PTH concentrations additionally allow an estimate of graft prognosis. This is particularly true in primary graft failure and in early rejection episodes.