Impact of parathyroidectomy on allograft outcomes in kidney transplantation
Hee Jung Jeon
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorYoon Jung Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorHyuk Yong Kwon
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Search for more papers by this authorTai Yeon Koo
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Search for more papers by this authorSeon Ha Baek
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorHyo-Jin Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorWoo Seong Huh
Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorKyu Ha Huh
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorMyoung Soo Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorYu Seun Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSu-Kil Park
Department of Internal Medicine, Ulsan University College of Medicine, Seoul, Korea
Search for more papers by this authorCurie Ahn
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorJaeseok Yang
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorHee Jung Jeon
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorYoon Jung Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorHyuk Yong Kwon
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Search for more papers by this authorTai Yeon Koo
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Search for more papers by this authorSeon Ha Baek
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorHyo-Jin Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorWoo Seong Huh
Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
Search for more papers by this authorKyu Ha Huh
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorMyoung Soo Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorYu Seun Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
Search for more papers by this authorSu-Kil Park
Department of Internal Medicine, Ulsan University College of Medicine, Seoul, Korea
Search for more papers by this authorCurie Ahn
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorJaeseok Yang
Transplantation Center, Seoul National University Hospital, Seoul, Korea
Transplantation Research Institute, Seoul National University College of Medicine, Seoul, Korea
Search for more papers by this authorConflicts of Interest: No conflict of interest.
Summary
We performed retrospective, multi-center study of the impacts of parathyroidectomy (PTX) after or before kidney transplantation on allograft outcomes. A total of 63 patients who underwent PTX after kidney transplantation were identified. Deterioration in eGFR by more than 25% at 1 month after PTX occurred in 20% of the patients. The baseline eGFR was significantly lower in impairment group than nonimpairment group [adjusted odds ratio (OR) 0.87, 95% confidence interval (CI) 0.77–0.99, P = 0.033]. Low iPTH concentration after PTX was also a significant risk factor for the renal impairment (OR 0.96, CI 0.94–0.99, P = 0.009). A total of 37 patients who underwent PTX before transplantation were identified. Thirty-six percent of the patients had persistent hyperparathyroidism by 1 year after transplantation. A high iPTH level before PTX was a significant risk factor for persistent post-transplant hyperparathyroidism (adjusted OR 1.002, CI 1.000–1.005, P = 0.039). Finally, eGFR values during the first 5 years after transplantation were significantly lower in the patients who underwent PTX at less than 1 year after transplantation, than the pretransplant PTX patients (P = 0.032). As PTX after kidney transplantation has a risk of deterioration of allograft function, pretransplant PTX should be considered for patients with severe hyperparathyroidism, who could undergo post-transplant PTX.
Supporting Information
Table S1. Risk factors for persistent, post-transplant hyperparathyroidism in patients that underwent parathyroidectomy before kidney transplantation.
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| TRI_1564_sm_TableS1.docx16 KB | Supporting info item |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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