[Changes in the pre-transplant bone-mineral metabolism do not affect the initial progress of the renal graft].
BACKGROUND
Abnormalities in serum calcium, phosphate, and Parathyroid Hormone (PTH) concentrations are common in patients with chronic kidney disease and have been associated with increased morbidity and mortality. One of the most common problems in the first weeks after renal transplantation is Delayed Graft Function (DGF). There are several well-known risk factors for DGF development, but the role of calcium phosphate-PTH homeostasis as a risk factor for early graft dysfunction is controversial. This issue was addressed in the current study.


METHODS
Pretransplant PTH, calcium and phosphate values were gathered in 449 patients that received a renal transplant in our center between 1994 and 2007. Other variables expected to influence the risk for delayed graft function were included from the clinical charts.


RESULTS
The incidence of DGF was 27.3%. DGF development was significantly associated with recipient age, type and need of renal replacement therapy, peak panel reactive antibodies, transfusion number and donor age. There were no significant differences in the mean pretransplant values of calcium (9.4 +/- 1.0 vs. 9.5 +/- 0.9 mg/dl, p = 0.667), phosphate (5.7 +/- 1.8 vs. 5.5 +/- 1.5 mg/dl, p = 0.457), calcium-phosphate product (53.5 +/- 17.2 vs. 51.8 +/- 14.6 mg(2)/dl(2), p = 0.413) and PTH (315 +/- 312 vs. 340 +/- 350 pg/ml, p = 0.530) between patients with and without DGF.


CONCLUSIONS
In our study population pretransplant serum PTH, calcium and phosphorus levels have no influence on the risk for DGF.
Rodrigo Calabia
E
E
Servicio de Nefrología, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain. nefrce@humv.es
Ruiz San Millán
J C
JC
Gago
M
M
Ruiz Criado
J
J
Piñera Haces
C
C
Fernández Fresnedo
G
G
Palomar
R
R
Gómez Alamillo
C
C
Martín de Francisco
A L
AL
Arias
M
M
D000328:Adult; D000367:Age Factors; D001803:Blood Transfusion; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000097:blood*; D051799:Delayed Graft Function / Q000453:epidemiology* / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D006934:Hypercalcemia / Q000097:blood; D006961:Hyperparathyroidism / Q000097:blood; D054559:Hyperphosphatemia / Q000097:blood; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010710:Phosphates / Q000097:blood*; D011300:Preoperative Care; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors / Q000706:statistics & numerical data
D010281:Parathyroid Hormone; D010710:Phosphates; D002118:Calcium