Endocrine Abstracts

Although serum calcium (Ca), phosphorus and parathyroid hormone (PTH) levels tend to normalize after successful kidney transplantation (KT), persistent hyperparathyroidism (PHPT) can have deleterious effects on graft function. We aimed to evaluate the effect of parathyroidectomy (PTx) on graft function in recipients after KT.

Methods: This retrospective study conducted in 319 adult KT recipients. PHPT is defined as serum corrected Ca level >10.2 mg/dl (at least twice in a 6 month period) and PTH >150 pg/ml at 6th month of KT.

Results: The mean follow up time was 49.4±1.4 months. Mean serum PTH levels before and at 12th month of KT and prevalence of hyperparathyroidism were 529±474 and 212±236 pg/ml, and 83.9% and 51.9%, respectively. Fifteen recipients with PHPT received cinacalcet for an average of 14.2±5.7 months. After cessation of cinacalcet therapy, serum Ca levels increased within 6 month. Mean serum Ca levels at 1st, 6th and 12th months of 12 recipients who underwent PTx before KT were 9.3±1.2, 9.6±0.8 and 9.2±1.2 mg/dl, respectively. The duration between PTx and KT in 16 recipients who underwent PTx after KT was 17.1±8.9 months (range 5–41 months). Two of 16 had operation at 5th and 1 at 7th month of KT because of severe hypercalcemia. Mean serum Ca levels of 16 recipients at 1st, 6th and 12th months of KT were 10.5±0.9, 10.8±0.9 and 10.6±0.9 mg/dl, respectively. There was no significant difference in graft function between post-transplant follow-ups in both groups.

Conclusion: In recipients who underwent Ptx before and after KT, PTx provided sustained decrease in serum Ca and PTH levels without affecting graft function.