Tags

Type your tag names separated by a space and hit enter

A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation.
Transplantation. 2016 Jan; 100(1):184-93.T

Abstract

BACKGROUND

Kidney transplantation corrects or improves many complications of chronic kidney disease, but its impact on disordered mineral metabolism is incompletely understood.

METHODS

We performed a multicenter, prospective, observational cohort study of 246 kidney transplant recipients in the United States to investigate the evolution of mineral metabolism from pretransplant through the first year after transplantation. Participants were enrolled into 2 strata defined by their pretransplant levels of parathyroid hormone (PTH), low PTH (>65 to ≤300 pg/mL; n = 112), and high PTH (>300 pg/mL; n = 134) and underwent repeated, longitudinal testing for mineral metabolites.

RESULTS

The prevalence of posttransplant, persistent hyperparathyroidism (PTH >65 pg/mL) was 89.5%, 86.8%, 83.1%, and 86.2%, at months 3, 6, 9, and 12, respectively, among participants who remained untreated with cinacalcet, vitamin D sterols, or parathyroidectomy. The results did not differ across the low and high PTH strata, and rates of persistent hyperparathyroidism remained higher than 40% when defined using a higher PTH threshold greater than 130 pg/mL. Rates of hypercalcemia peaked at 48% at week 8 in the high PTH stratum and then steadily decreased through month 12. Rates of hypophosphatemia (<2.5 mg/dL) peaked at week 2 and then progressively decreased through month 12. Levels of intact fibroblast growth factor 23 decreased rapidly during the first 3 months after transplantation in both PTH strata and remained less than 40 pg/mL thereafter.

CONCLUSIONS

Persistent hyperparathyroidism is common after kidney transplantation. Further studies should determine if persistent hyperparathyroidism or its treatment influences long-term posttransplantation clinical outcomes.

Authors+Show Affiliations

1 Division of Nephrology and Hypertension, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL. 2 Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD. 3 Lehigh Valley Hospital, Allentown, PA. 4 University of Alabama at Birmingham, Birmingham, AL. 5 The Ohio State University Medical Center, Columbus, OH. 6 Amgen Inc., Thousand Oaks, CA. 7 Kidney Transplant Service, University of California San Francisco, San Francisco, CA.No 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
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26177089

Citation

Wolf, Myles, et al. "A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation." Transplantation, vol. 100, no. 1, 2016, pp. 184-93.
Wolf M, Weir MR, Kopyt N, et al. A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. Transplantation. 2016;100(1):184-93.
Wolf, M., Weir, M. R., Kopyt, N., Mannon, R. B., Von Visger, J., Deng, H., Yue, S., & Vincenti, F. (2016). A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. Transplantation, 100(1), 184-93. https://doi.org/10.1097/TP.0000000000000823
Wolf M, et al. A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. Transplantation. 2016;100(1):184-93. PubMed PMID: 26177089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. AU - Wolf,Myles, AU - Weir,Matthew R, AU - Kopyt,Nelson, AU - Mannon,Roslyn B, AU - Von Visger,Jon, AU - Deng,Hongjie, AU - Yue,Susan, AU - Vincenti,Flavio, PY - 2015/7/16/entrez PY - 2015/7/16/pubmed PY - 2016/4/19/medline SP - 184 EP - 93 JF - Transplantation JO - Transplantation VL - 100 IS - 1 N2 - BACKGROUND: Kidney transplantation corrects or improves many complications of chronic kidney disease, but its impact on disordered mineral metabolism is incompletely understood. METHODS: We performed a multicenter, prospective, observational cohort study of 246 kidney transplant recipients in the United States to investigate the evolution of mineral metabolism from pretransplant through the first year after transplantation. Participants were enrolled into 2 strata defined by their pretransplant levels of parathyroid hormone (PTH), low PTH (>65 to ≤300 pg/mL; n = 112), and high PTH (>300 pg/mL; n = 134) and underwent repeated, longitudinal testing for mineral metabolites. RESULTS: The prevalence of posttransplant, persistent hyperparathyroidism (PTH >65 pg/mL) was 89.5%, 86.8%, 83.1%, and 86.2%, at months 3, 6, 9, and 12, respectively, among participants who remained untreated with cinacalcet, vitamin D sterols, or parathyroidectomy. The results did not differ across the low and high PTH strata, and rates of persistent hyperparathyroidism remained higher than 40% when defined using a higher PTH threshold greater than 130 pg/mL. Rates of hypercalcemia peaked at 48% at week 8 in the high PTH stratum and then steadily decreased through month 12. Rates of hypophosphatemia (<2.5 mg/dL) peaked at week 2 and then progressively decreased through month 12. Levels of intact fibroblast growth factor 23 decreased rapidly during the first 3 months after transplantation in both PTH strata and remained less than 40 pg/mL thereafter. CONCLUSIONS: Persistent hyperparathyroidism is common after kidney transplantation. Further studies should determine if persistent hyperparathyroidism or its treatment influences long-term posttransplantation clinical outcomes. SN - 1534-6080 UR - https://www.unboundmedicine.com/medline/citation/26177089/A_Prospective_Cohort_Study_of_Mineral_Metabolism_After_Kidney_Transplantation_ L2 - https://doi.org/10.1097/TP.0000000000000823 DB - PRIME DP - Unbound Medicine ER -