Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
- A Randomized Study Comparing Parathyroidectomy Versus Cinacalcet to Treat Hypercalcemia in Kidney Allograft Recipients With Persistent Hyperparathyroidism
- Persistent Tertiary Hyperparathyroidism in the First Year after Kidney Transplantation is Associated with Calcium Phosphate Deposition in the Kidney Allograft
*Purpose: Tertiary hyperparathyroidism (THPT) is a condition in which hyperparathyroidism persists after renal transplantation (RTx), and is a frequent complication. The aim of this retrospective cohort study is to clarify whether the adverse effect of THPT on the renal graft survival depends on serum calcium levels.
*Methods: Among 863 consecutive RTx, 422 didn’t have THPT (nHPT group), 392 have normocalcemic THPT (NC-HPT group) and 49 have hypercalcemic (serum calcium levels > 10.6mg/dL) THPT (HC-HPT group) after 6 months from successful RTx. Graft survival was compared among the groups, and cox proportional hazard regression analysis was conducted for graft survival.
*Results: Overall graft survival in HC-HPT was significantly lower among the three study groups (91.7% vs 86.1% vs 76.9% in the nHPT, NC-HPT and HC-HPT groups at ten years after RTx, P = 0.04). Cox hazard analysis revealed that hypercalcemic THPT was an independent risk factor for graft loss (P=0.04, hazard ratio 2.25; 95% confidence interval 1.02-4.99), however the association between normocalcemic THPT and graft loss wasn’t shown to be statistically significant (P=0.13, hazard ratio 1.45; 95% confidence interval 0.90-2.33).
*Conclusions: Hypercalcemic THPT should be treated aggressively because of its adverse effect for long-term graft survival in RTx.
|Factor||Hazard ratio||95% confidence interval||P value|
|HLA incompatible RTx||3.14||1.39-7.09||0.006|
|Dialysis duration (month)||1.00||1.00-1.00||0.690|
To cite this abstract in AMA style:Okada M, Tomosugi T, Hiramitsu T, Futamura K, Kanda A, Goto N, Narumi S, Ichimori T, Watarai Y. Calcium Level-Dependence of the Adverse Effect of Tertiary Hyperparathyroidism on Graft Survival in Renal Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/calcium-level-dependence-of-the-adverse-effect-of-tertiary-hyperparathyroidism-on-graft-survival-in-renal-transplant-recipients/. Accessed March 7, 2021.
« Back to 2020 American Transplant Congress