title: Hypocalcemia immediately after renal transplantation.
abstract: BACKGROUND
  After renal transplantation (RTX), hypercalcemia, mainly due to persistent hyperparathyroidism, and hypophosphatemia, caused by the improved ability to excrete phosphorus in the renal tubules, are expected. However, immediately after RTX, a transient reduction in serum calcium (Ca) levels has been previously reported, the reason for which is not clear.
  
  
  METHODS
  In 21 patients receiving ABO compatible living donor kidney transplants, serum levels of Ca, phosphorus, intact parathyroid hormone (iPTH), 1,25-dihydroxyvitamin D, and tacrolimus were measured within three wk after RTX, along with urinary Ca and phosphorus excretion. The immunosuppressive regimen consisted of a three-drug combination including a glucocorticoid, a calcineurin inhibitor, and an antimetabolite agent.
  
  
  RESULTS
  Serum Ca levels declined significantly during the first post-operative week. Urinary Ca excretion increased immediately after RTX and gradually normalized. Increased urinary Ca excretion did not correlate with serum levels of iPTH and tacrolimus.
  
  
  CONCLUSIONS
  Immediately after RTX, regardless of serum iPTH and tacrolimus levels, transient increases in urinary Ca excretion and hypocalcemia were observed. Administration of glucocorticoids is one potential cause of inappropriate urinary Ca wasting.
authors.affiliation: Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Nobata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Tominaga
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Imai
authors.forename: Kazuharu
authors.initials: K
authors.lastname: Uchida
mesh_terms: D002118:Calcium / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006996:Hypocalcemia / Q000097:blood / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors
chemical_list: D002118:Calcium
keywords: hypocalcemia; intact parathyroid hormone; renal transplantation; tacrolimus; urinary calcium excretion