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Recovery of hyperphosphatoninism and renal phosphorus wasting one year after successful renal transplantation.
Clin J Am Soc Nephrol. 2008 Nov; 3(6):1829-36.CJ

Abstract

BACKGROUND AND OBJECTIVES

In the first months after successful kidney transplantation, hypophosphatemia and renal phosphorus wasting are common and related to inappropriately high parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23) levels. Little is known about the long-term natural history of renal phosphorus homeostasis in renal transplant recipients.

DESIGN, SETTING, PARTICIPANTS

We prospectively followed parameters of mineral metabolism (including full-length PTH and FGF-23) in 50 renal transplant recipients at the time of transplantation (Tx), at month 3 (M3) and at month 12 (M12). Transplant recipients were (1:1) matched for estimated GFR with chronic kidney disease (CKD) patients.

RESULTS

FGF-23 levels (Tx: 2816 [641 to 10665] versus M3: 73 [43 to 111] versus M12: 56 [34 to 78] ng/L, median [interquartile range]) and fractional phosphorus excretion (FE(phos); M3: 45 +/- 19% versus M12: 37 +/- 13%) significantly declined over time after renal transplantation. Levels 1 yr after transplantation were similar to those in CKD patients (FGF-23: 47 [34 to 77] ng/L; FE(phos) 35 +/- 16%). Calcium (9.1 +/- 0.5 versus 8.9 +/- 0.3 mg/dl) and PTH (27.2 [17.0 to 46.0] versus 17.5 [11.7 to 24.4] ng/L) levels were significantly higher, whereas phosphorus (3.0 +/- 0.6 versus 3.3 +/- 0.6 mg/dl) levels were significantly lower 1 yr after renal transplantation as compared with CKD patients.

CONCLUSIONS

Data indicate that hyperphosphatoninism and renal phosphorus wasting regress by 1 yr after successful renal transplantation.

Authors+Show Affiliations

Department of Medicine, Division of Nephrology, University Hospital Leuven, B-3000 Leuven, Belgium. Pieter.Evenepoel@uz.kuleuven.ac.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18922992

Citation

Evenepoel, Pieter, et al. "Recovery of Hyperphosphatoninism and Renal Phosphorus Wasting One Year After Successful Renal Transplantation." Clinical Journal of the American Society of Nephrology : CJASN, vol. 3, no. 6, 2008, pp. 1829-36.
Evenepoel P, Meijers BK, de Jonge H, et al. Recovery of hyperphosphatoninism and renal phosphorus wasting one year after successful renal transplantation. Clin J Am Soc Nephrol. 2008;3(6):1829-36.
Evenepoel, P., Meijers, B. K., de Jonge, H., Naesens, M., Bammens, B., Claes, K., Kuypers, D., & Vanrenterghem, Y. (2008). Recovery of hyperphosphatoninism and renal phosphorus wasting one year after successful renal transplantation. Clinical Journal of the American Society of Nephrology : CJASN, 3(6), 1829-36. https://doi.org/10.2215/CJN.01310308
Evenepoel P, et al. Recovery of Hyperphosphatoninism and Renal Phosphorus Wasting One Year After Successful Renal Transplantation. Clin J Am Soc Nephrol. 2008;3(6):1829-36. PubMed PMID: 18922992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recovery of hyperphosphatoninism and renal phosphorus wasting one year after successful renal transplantation. AU - Evenepoel,Pieter, AU - Meijers,Bjorn K I, AU - de Jonge,Hylke, AU - Naesens,Maarten, AU - Bammens,Bert, AU - Claes,Kathleen, AU - Kuypers,Dirk, AU - Vanrenterghem,Yves, Y1 - 2008/10/15/ PY - 2008/10/17/pubmed PY - 2009/1/7/medline PY - 2008/10/17/entrez SP - 1829 EP - 36 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 3 IS - 6 N2 - BACKGROUND AND OBJECTIVES: In the first months after successful kidney transplantation, hypophosphatemia and renal phosphorus wasting are common and related to inappropriately high parathyroid hormone (PTH) and fibroblast growth factor-23 (FGF-23) levels. Little is known about the long-term natural history of renal phosphorus homeostasis in renal transplant recipients. DESIGN, SETTING, PARTICIPANTS: We prospectively followed parameters of mineral metabolism (including full-length PTH and FGF-23) in 50 renal transplant recipients at the time of transplantation (Tx), at month 3 (M3) and at month 12 (M12). Transplant recipients were (1:1) matched for estimated GFR with chronic kidney disease (CKD) patients. RESULTS: FGF-23 levels (Tx: 2816 [641 to 10665] versus M3: 73 [43 to 111] versus M12: 56 [34 to 78] ng/L, median [interquartile range]) and fractional phosphorus excretion (FE(phos); M3: 45 +/- 19% versus M12: 37 +/- 13%) significantly declined over time after renal transplantation. Levels 1 yr after transplantation were similar to those in CKD patients (FGF-23: 47 [34 to 77] ng/L; FE(phos) 35 +/- 16%). Calcium (9.1 +/- 0.5 versus 8.9 +/- 0.3 mg/dl) and PTH (27.2 [17.0 to 46.0] versus 17.5 [11.7 to 24.4] ng/L) levels were significantly higher, whereas phosphorus (3.0 +/- 0.6 versus 3.3 +/- 0.6 mg/dl) levels were significantly lower 1 yr after renal transplantation as compared with CKD patients. CONCLUSIONS: Data indicate that hyperphosphatoninism and renal phosphorus wasting regress by 1 yr after successful renal transplantation. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/18922992/Recovery_of_hyperphosphatoninism_and_renal_phosphorus_wasting_one_year_after_successful_renal_transplantation_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=18922992 DB - PRIME DP - Unbound Medicine ER -