Parathyroid hormone levels in long-term renal transplant children and adolescents
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Isabella Guzzo & Giacomo Di Zazzo & Chiara Laurenzi & Lucilla Ravà & Germana Giannone & Stefano Picca & Luca Dello Strologo
- چاپ و سال / کشور: 2011
Description
Secondary hyperparathyroidism is a common complication of chronic renal failure. Kidney transplantation corrects renal insufficiency and most metabolic abnormalities but hyperparathyroidism persists in 50% of children after transplantation. The aim of this study was to investigate parathyroid hormone (PTH) course and potential risk factors for hyperparathyroidism in children after renal transplant. We collected data from 145 transplanted children (mean follow-up 4.7 years). Intact PTH level (iPTH) rapidly decreased in the first 6 months posttransplant and continued to decline in the following years. iPTH was above the normal range in 69.1% of the patients at the time of transplant and in 47% 1 year later, this improvement continuing thereafter. Hypercalcemia was present in 20.3% of the patients before transplant and in 6.3 and 4.1% of patients 6 months and 1 year after transplant, respectively. Hypophosphatemia was present in 5.5% of the patients at 6 months, and 45.5% of the patients needed phosphorus supplements during the first 6 months after transplant. Multivariate analysis indicated pre-transplant hyperparathyroidism, dialysis duration, creatinine clearance and hypophosphatemia as predictors of persistent hyperparathyroidism. In kidney transplanted children, serum iPTH normalized in the long term in the majority of cases. Thus, parathyroidectomy should be reserved for selected patients.
Pediatr Nephrol DOI 10.1007/s00467-011-1896-8 Received: 9 October 2010 / Revised: 14 March 2011 / Accepted: 15 March 2011
