title: Mineral metabolism in European children living with a renal transplant: a European society for paediatric nephrology/european renal association-European dialysis and transplant association registry study.
abstract: OBJECTIVE
  Data on mineral metabolism in pediatric renal transplant recipients largely arise from small single-center studies. In adult patients, abnormal mineral levels are related to a higher risk of graft failure. This study used data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association Registry to study the prevalence and potential determinants of mineral abnormalities, as well as the predictive value of a disturbed mineral level on graft survival in a large cohort of European pediatric renal transplant recipients.
  
  
  METHODS
  This study included 1237 children (0-17 years) from 10 European countries, who had serum calcium, phosphorus, and parathyroid hormone measurements from 2000 onward. Abnormalities of mineral metabolism were defined according to European guidelines on prevention and treatment of renal osteodystrophy in children on chronic renal failure.
  
  
  RESULTS
  Abnormal serum phosphorus levels were observed in 25% (14% hypophosphatemia and 11% hyperphosphatemia), altered serum calcium in 30% (19% hypocalcemia, 11% hypercalcemia), and hyperparathyroidism in 41% of the patients. A longer time since transplantation was associated with a lower risk of having mineral levels above target range. Serum phosphorus levels were inversely associated with eGFR, and levels above the recommended targets were associated with a higher risk of graft failure independently of eGFR.
  
  
  CONCLUSIONS
  Abnormalities in mineral metabolism are common after pediatric renal transplantation in Europe and are associated with graft dysfunction.
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Bonthuis
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Marco
authors.initials: M
authors.lastname: Busutti
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material. K.J.vanStralen@amc.uva.nl.
authors.forename: Karlijn J
authors.initials: KJ
authors.lastname: van Stralen
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Sergey
authors.initials: S
authors.lastname: Baiko
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Sevcan
authors.initials: S
authors.lastname: Bakkaloğlu
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Nina
authors.initials: N
authors.lastname: Battelino
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Maria
authors.initials: M
authors.lastname: Gaydarova
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Bruno
authors.initials: B
authors.lastname: Gianoglio
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Paloma
authors.initials: P
authors.lastname: Parvex
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Clara
authors.initials: C
authors.lastname: Gomes
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: James G
authors.initials: JG
authors.lastname: Heaf
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Podracka
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Dafina
authors.initials: D
authors.lastname: Kuzmanovska
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Maria S
authors.initials: MS
authors.lastname: Molchanova
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Tatiana E
authors.initials: TE
authors.lastname: Pankratenko
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Fotios
authors.initials: F
authors.lastname: Papachristou
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: György
authors.initials: G
authors.lastname: Reusz
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Sanahuja
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Rukshana
authors.initials: R
authors.lastname: Shroff
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.affiliation: Due to the number of contributing authors,the affiliations are provided in the Supplemental Material.
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
mesh_terms: D000293:Adolescent; D002118:Calcium / Q000097:blood; D002648:Child; D002675:Child, Preschool; D005060:Europe / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D006934:Hypercalcemia / Q000453:epidemiology*; D006962:Hyperparathyroidism, Secondary / Q000453:epidemiology*; D054559:Hyperphosphatemia / Q000453:epidemiology*; D006996:Hypocalcemia / Q000453:epidemiology*; D017674:Hypophosphatemia / Q000453:epidemiology*; D007223:Infant; D007231:Infant, Newborn; D016030:Kidney Transplantation; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D012042:Registries
chemical_list: D010281:Parathyroid Hormone; D010758:Phosphorus; D002118:Calcium
keywords: calcium; epidemiology and outcomes; hyperphosphatemia; pediatric kidney transplantation; transplant outcomes