title: Renal allograft failure in a hyperparathyroid patient following initiation of a calcimimetic.
abstract: BACKGROUND
  A 47-year-old man with a 6-year history of chronic dialysis for end-stage renal disease of unknown etiology presented for renal transplantation. While on dialysis, he had developed secondary hyperparathyroidism, which persisted after transplantation despite treatment with cinacalcet.
  
  
  METHODS
  Physical examination, serum and urine analysis, ultrasound of the renal transplant, renal biopsy, bone scintigraphy.
  
  
  METHODS
  Severe persistent hyperparathyroidism associated with mild hypercalcemia following renal transplantation. Initiation of a calcimimetic followed by fulminant graft failure. Extensive tubular calcinosis.
  
  
  RESULTS
  Renal transplantation (with immunosuppressant medications: basiliximab, tacrolimus, mycophenolate mofetil, prednisolone), cinacalcet (halted on day 26 after transplantation), angiotensinconverting-enzyme inhibitor, angiotensin-receptor blocker, hydrochlorothiazide, emergency dialysis, subtotal parathyroidectomy.
authors.affiliation: Division of Nephrology and Immunology, RWTH University of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. cseikrit@ukaachen.de
authors.forename: Claudia
authors.initials: C
authors.lastname: Seikrit
authors.forename: Anja
authors.initials: A
authors.lastname: Mühlfeld
authors.forename: Hermann-Josef
authors.initials: HJ
authors.lastname: Groene
authors.forename: Jürgen
authors.initials: J
authors.lastname: Floege
mesh_terms: D000069449:Cinacalcet; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000188:drug therapy*; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009281:Naphthalenes / Q000009:adverse effects*; D009397:Nephrocalcinosis / Q000139:chemically induced*; D011183:Postoperative Complications / Q000188:drug therapy; D014184:Transplantation, Homologous
chemical_list: D009281:Naphthalenes; D000069449:Cinacalcet