title: Hyperparathyroidism and new onset diabetes after renal transplantation.
abstract: BACKGROUND
  Secondary hyperparathyroidism persists after renal transplantation in a substantial number of patients. Primary hyperparathyroidism and secondary hyperparathyroidism are both associated with abnormalities in glucose metabolism, such as insufficient insulin release and glucose intolerance. The association of hyperparathyroidism and diabetes after renal transplantation has, as far as we know, not been studied. Our aim was to investigate whether hyperparathyroidism is associated with new-onset diabetes mellitus after transplantation (NODAT) during the first year posttransplantation.
  
  
  METHODS
  In a retrospective study, we analyzed data on patient characteristics, treatment details, and parathyroid hormone (PTH) in 245 adult nondiabetic patients who underwent renal transplantation between January 2000 and June 2011.
  
  
  RESULTS
  The first year cumulative incidence of NODAT was 15%. The first serum PTH value after transplantation was above normal range in 74% of the patients. In multiple logistic regression analysis, PTH levels above twice normal range (>13.80 pmol/L) were significantly associated with NODAT (odds ratio [OR], 4.25; 95% confidence interval [CI], 1.13-15.92; P = .03) compared with PTH within normal range (≤6.9 pmol/L). Age between 45 and 65 years (OR, 2.80; 95% CI, 1.07-7.36; P = .04) compared with age <45 years was also associated with NODAT.
  
  
  CONCLUSIONS
  We found a strong association between hyperparathyroidism and NODAT in the first year after renal transplantation. Both conditions are common and have a negative impact on graft and patient survivals. Our results should be confirmed in prospective studies.
authors: Department of Nephrology, Clinical Sciences Lund, Lund University, Lund, Sweden.
authors: K M
authors: KM
authors: Ivarsson
authors: Department of Nephrology, Clinical Sciences Lund, Lund University, Lund, Sweden.
authors: N
authors: N
authors: Clyne
authors: Department of Surgery, Clinical Sciences Lund, Lund University, Lund, Sweden.
authors: M
authors: M
authors: Almquist
authors: Department of Nephrology, Clinical Sciences Lund, Lund University, Lund, Sweden. Electronic address: shahriar.akaberi@med.lu.se.
authors: S
authors: S
authors: Akaberi
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000175:diagnosis*; D003920:Diabetes Mellitus / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism; D005951:Glucose Tolerance Test; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications* / Q000175:diagnosis; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007328:Insulin / Q000378:metabolism; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010281:Parathyroid Hormone / Q000097:blood; D012044:Regression Analysis; D051437:Renal Insufficiency / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D007328:Insulin; D010281:Parathyroid Hormone; D005947:Glucose