Korean J Nephrol.  2007 Sep;26(5):601-609.

Change of Parathyroid Hormone and Markers of Bone Metabolism after Renal Transplantation

• Kim JE
• Hwang EA
• Kwak JH
• Jin KB
• Yoon JS
• Han SY
• Park SB
• Kim HC

Abstract

PURPOSE: The aims of this retrospective study were to evaluate the sequential changes of parathyroid hormone (iPTH) and calcium metabolism after renal transplantation (RTP) and to identify risk factors for hypertension (HPT).
METHODS
Biochemical bone parameters were reviewed in 264 patients at pre-transplant, 6, 12, 36 and 60 months after RTP.
RESULTS
iPTH levels fell significantly during the first six months after RTP and remained substantially stable thereafter. The mean total serum calcium level showed significant increase during the first six months and progressive and significant decline after the first year. The mean serum phosphorus level returned to the normal range during the first six months and remained normal thereafter. The serum alkaline phosphatase (ALP) level increased during the first year and gradually decreased after then. The prevalence of persistent HPT was 17.8%. Patients with persistent HPT had significantly elevated serum levels of iPTH at the time of RTP and had spent a longer time on dialysis. Significant positive correlations were observed between the serum iPTH levels on the one hand and the pre-transplant iPTH, serum ALP, and creatinine levels on the other hand.
CONCLUSION
The prevalence of persistent HPT after RTP is not uncommon. The patients with long duration of dialysis showing high serum level of iPTH at the time of transplantation are at risk for persistent HPT.

Keyword

Calcium; Secondary hyperparathyroidism; Phosphorus; Renal transplantation

MeSH Terms

Alkaline Phosphatase
Calcium
Creatinine
Dialysis
Hand
Humans
Hyperparathyroidism, Secondary
Hypertension
Kidney Transplantation*
Metabolism*
Parathyroid Hormone*
Phosphorus
Prevalence
Reference Values
Retrospective Studies
Risk Factors
Alkaline Phosphatase
Calcium
Creatinine
Parathyroid Hormone
Phosphorus