title: Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function.
abstract: BACKGROUND
  The aim of the study was to investigate whether serum levels of intact parathyroid hormone (iPTH) are associated with an increased risk of cardiovascular events, graft loss, or mortality in kidney transplant patients with optimal transplant function.
  
  
  METHODS
  From the Norwegian Renal Registry, we identified 522 patients who received a first kidney transplant from 2001 to 2008 with optimal transplant function defined as an estimated glomerular filtration rate (eGFR)≥60 mL/min/1.73 m2, more than one yr after transplantation. Cox's proportional hazard models were used to assess the association between iPTH measured 10 wk after transplantation and the composite endpoint. The estimates were adjusted for age, gender, serum calcium, serum phosphate, diabetes mellitus, cardiovascular disease, and time on dialysis prior to transplantation.
  
  
  RESULTS
  Median follow-up time was 3.9 yr (interquartile range, IQR: 2.0-6.0 yr). Patients in the third iPTH quartile (9.3-14.4 pM) had the lowest risk for reaching the composite endpoint. Patients in the fourth iPTH quartile (>14.4 pM) had an increased risk compared to those in the third quartile (HR: 2.60, 95% CI: 1.10-6.16, p=0.03).
  
  
  CONCLUSIONS
  In patients with optimal transplant function, iPTH levels are associated with a clinical outcome consisting of cardiovascular events, graft loss, and all-cause mortality.
authors: Department of Medicine, Stavanger University Hospital, Stavanger, Norway.
authors: Inger H
authors: IH
authors: Bleskestad
authors: Harald
authors: H
authors: Bergrem
authors: Torbjørn
authors: T
authors: Leivestad
authors: Anders
authors: A
authors: Hartmann
authors: Lasse G
authors: LG
authors: Gøransson
mesh_terms: D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000097:blood* / Q000209:etiology / Q000401:mortality; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011183:Postoperative Complications; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D002118:Calcium
keywords: cardiovascular disease; chronic kidney disease mineral and bone disorder; kidney transplantation; parathyroid hormone; secondary hyperparathyroidism