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A case study with delayed renal graft function as a consequence of severe secondary hyperparathyroidism
U Backman1, G Butler, P Fletchner
1Ibn AI Bitar Hospital, Baghdad, Iraq.
Artificial Organs
|January 1, 1995
Summary
Severe secondary hyperparathyroidism in a kidney transplant patient caused crystal deposition and delayed graft function. Parathyroidectomy resolved the issue, indicating it
Area of Science:
- Nephrology
- Endocrinology
- Transplantation
Background:
- A 36-year-old man with end-stage renal disease on hemodialysis for 6 years developed severe secondary hyperparathyroidism.
- The patient did not receive phosphate binders or 1,25-dihydroxy-vitamin D3, leading to complications like bone disease and soft-tissue calcification.
Observation:
- Following a kidney transplant, the patient experienced delayed graft function.
- A biopsy revealed crystal deposition in the graft, presumed to be related to severe secondary hyperparathyroidism.
- Despite persistent graft dysfunction, a parathyroidectomy was performed four weeks post-transplant.
Findings:
- Graft function recovered a few days after parathyroidectomy.
- The extent of crystal deposition in the kidney decreased post-parathyroidectomy.
- This suggests a direct link between severe secondary hyperparathyroidism and delayed renal graft function.
Implications:
- Severe secondary hyperparathyroidism can significantly impede immediate renal graft function post-transplantation.
- Crystal deposition in the graft, associated with hyperparathyroidism, may lead to graft dysfunction.
- Parathyroidectomy should be considered an essential intervention for patients with crystal deposition and graft dysfunction.