title: Parathyroid function in long-term renal transplant patients: importance of pre-transplant PTH concentrations.
abstract: Lack of resolution of hyperparathyroidism after long-term renal transplantation is common. The relative roles of the graft function attained and the degree of pre-transplant hyperparathyroidism have not been established. Intact parathyroid hormone (iPTH) and several clinical parameters were studied before and 68.6+/-26.8 months (range: 30-124) after renal transplantation in 62 patients (20 females/42 males) with good renal function (creatinine <2 mg/dl). iPTH decreased from 214+/-229 pre-transplantation to 116+/-70 pg/ml post-transplantation (P<0.01). However, only 22.6% of patients had PTH concentrations in the normal range, and values greater than twice the upper normal limit were not uncommon (27.4%). Of the many variables analysed, creatinine (r=0.43; P=0.001) and pre-transplant PTH (r=0.31; P=0.02) significantly correlated with post-transplant PTH. After selecting patients with serum creatinine <1.5 mg/dl (n=46), pre-transplant PTH emerged as the more important predictor of post-transplant PTH (r=0.58; P<0.0001). After controlling for creatinine, the partial correlation was r=0.53, P<0.0001. We concluded that spontaneous resolution of hyperparathyroidism after renal transplantation is uncommon. In addition, the magnitude of pre-transplant hyperparathyroidism and the renal function determine the long-term post-transplant parathyroid function.
authors.affiliation: Servicio de Nefrología, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Torres
authors.forename: A P
authors.initials: AP
authors.lastname: Rodríguez
authors.forename: M T
authors.initials: MT
authors.lastname: Concepción
authors.forename: S
authors.initials: S
authors.lastname: García
authors.forename: M
authors.initials: M
authors.lastname: Rufino
authors.forename: B
authors.initials: B
authors.lastname: Martín
authors.forename: L
authors.initials: L
authors.lastname: Pérez
authors.forename: M
authors.initials: M
authors.lastname: Machado
authors.forename: E
authors.initials: E
authors.lastname: de Bonis
authors.forename: M
authors.initials: M
authors.lastname: Losada
authors.forename: D
authors.initials: D
authors.lastname: Hernández
authors.forename: V
authors.initials: V
authors.lastname: Lorenzo
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000503:physiopathology*; D010281:Parathyroid Hormone / Q000097:blood*
chemical_list: D010281:Parathyroid Hormone