title: Kidney allograft failure due to acute phosphate nephropathy associated with severe secondary hyperparathyroidism.
abstract: Intratubular calcification is a common finding in renal allografts. However, possible harmful effect of this calcification is not well recognized, and allograft failure purely due to this condition has not been reported. We report a kidney transplant recipient who suffered from severe secondary hyperparathyroidism and unexplained early allograft failure. A diagnosis of acute phosphate nephropathy was made subsequently based on serial allograft biopsy findings. This case calls for a high index of suspicion to look for this rare cause of allograft dysfunction among high-risk patients. It also highlights the importance of good calcium-phosphate control before renal transplantation.
authors.affiliation: Renal Unit, Department of Medicine & Geriatrics, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Ping-Nam
authors.initials: PN
authors.lastname: Wong
authors.affiliation: Department of Pathology, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Alice N H
authors.initials: AN
authors.lastname: Chan
authors.affiliation: Renal Unit, Department of Medicine & Geriatrics, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Kin-Yee
authors.initials: KY
authors.lastname: Lo
authors.affiliation: Renal Unit, Department of Medicine & Geriatrics, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Yuk-Yi
authors.initials: YY
authors.lastname: Wong
authors.affiliation: Renal Unit, Department of Medicine & Geriatrics, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Siu-Ka
authors.initials: SK
authors.lastname: Mak
authors.affiliation: Renal Unit, Department of Medicine & Geriatrics, Kwong Wah Hospital, Hong Kong SAR, China.
authors.forename: Andrew K M
authors.initials: AK
authors.lastname: Wong
keywords: acute phosphate nephropathy; hyperparathyroidism; nephrocalcinosis; tubular injury