title: Impact of parathyroidectomy on allograft outcomes in kidney transplantation.
abstract: We performed retrospective, multi-center study of the impacts of parathyroidectomy (PTX) after or before kidney transplantation on allograft outcomes. A total of 63 patients who underwent PTX after kidney transplantation were identified. Deterioration in eGFR by more than 25% at 1 month after PTX occurred in 20% of the patients. The baseline eGFR was significantly lower in impairment group than nonimpairment group [adjusted odds ratio (OR) 0.87, 95% confidence interval (CI) 0.77-0.99, P = 0.033]. Low iPTH concentration after PTX was also a significant risk factor for the renal impairment (OR 0.96, CI 0.94-0.99, P = 0.009). A total of 37 patients who underwent PTX before transplantation were identified. Thirty-six percent of the patients had persistent hyperparathyroidism by 1 year after transplantation. A high iPTH level before PTX was a significant risk factor for persistent post-transplant hyperparathyroidism (adjusted OR 1.002, CI 1.000-1.005, P = 0.039). Finally, eGFR values during the first 5 years after transplantation were significantly lower in the patients who underwent PTX at less than 1 year after transplantation, than the pretransplant PTX patients (P = 0.032). As PTX after kidney transplantation has a risk of deterioration of allograft function, pretransplant PTX should be considered for patients with severe hyperparathyroidism, who could undergo post-transplant PTX.
authors.affiliation: Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: Jeon
authors.forename: Yoon Jung
authors.initials: YJ
authors.lastname: Kim
authors.forename: Hyuk Yong
authors.initials: HY
authors.lastname: Kwon
authors.forename: Tai Yeon
authors.initials: TY
authors.lastname: Koo
authors.forename: Seon Ha
authors.initials: SH
authors.lastname: Baek
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Woo Seong
authors.initials: WS
authors.lastname: Huh
authors.forename: Kyu Ha
authors.initials: KH
authors.lastname: Huh
authors.forename: Myoung Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.forename: Su-Kil
authors.initials: SK
authors.lastname: Park
authors.forename: Curie
authors.initials: C
authors.lastname: Ahn
authors.forename: Jaeseok
authors.initials: J
authors.lastname: Yang
mesh_terms: D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology; D008297:Male; D010281:Parathyroid Hormone; D016105:Parathyroidectomy; D012189:Retrospective Studies; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone