title: The relative role of fibroblast growth factor 23 and parathyroid hormone in predicting future hypophosphatemia and hypercalcemia after living donor kidney transplantation: a 1-year prospective observational study.
abstract: BACKGROUND
  Kidney transplantation (KTx) restores many of the disorders accompanying end-stage renal failure. However, hypercalcemia and hypophosphatemia are both common complications after renal transplantation. Prospective observation of these complications has not been well described and pre-transplant predictors also remain unknown. This prospective observational cohort study was carried out to clarify pre-transplant risk factors of persistent hypophosphatemia and/or hypercalcemia at 12 months after transplantation.
  
  
  METHODS
  Consecutive living donor KTx recipients (n = 39) at Tokyo Women's Medical University were prospectively recruited. Parameters of bone and mineral metabolism including intact parathyroid hormone (iPTH) and full-length fibroblast growth factor (FGF) 23 were followed.
  
  
  RESULTS
  FGF23 decreased to comparable levels for renal function while hyperparathyroidism persisted at 12 months after transplantation. Multivariate linear regression analysis revealed that pre-transplant iPTH correlated with hypercalcemia at 12 months and pre-transplant FGF23 was the best pre-transplant predictor of persistent hypophosphatemia at 12 months.
  
  
  CONCLUSIONS
  It is intriguing that although FGF23 is not a causal factor for hypophosphatemia at 12 months post-transplantation, it is a significant predictor of this common complication.
authors.affiliation: Department of Nephrology and Endocrinology, University of Tokyo, Tokyo, Japan. hirookawarazaki@yahoo.co.jp
authors.forename: Hiroo
authors.initials: H
authors.lastname: Kawarazaki
authors.forename: Yugo
authors.initials: Y
authors.lastname: Shibagaki
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukumoto
authors.forename: Ryo
authors.initials: R
authors.lastname: Kido
authors.forename: Ichiro
authors.initials: I
authors.lastname: Nakajima
authors.forename: Shohei
authors.initials: S
authors.lastname: Fuchinoue
authors.forename: Toshiro
authors.initials: T
authors.lastname: Fujita
authors.forename: Masafumi
authors.initials: M
authors.lastname: Fukagawa
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teraoka
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D002118:Calcium / Q000097:blood; D015331:Cohort Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005500:Follow-Up Studies; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D006961:Hyperparathyroidism / Q000097:blood / Q000209:etiology; D017674:Hypophosphatemia / Q000097:blood / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000628:therapy; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010710:Phosphates / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D010710:Phosphates; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium