Impact of parathyroidectomy on allograft outcomes in kidney transplantation

Hee Jung Jeon, Yoon Jung Kim, Hyuk Yong Kwon, Tai Yeon Koo, Seon Ha Baek, Hyo Jin Kim, Woo Seong Huh, Kyu Ha Huh, Myoung Soo Kim, Yu Seun Kim, Su Kil Park, Curie Ahn, Jaeseok Yang

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Abstract

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.

Original languageEnglish
Pages (from-to)1248-1256
Number of pages9
JournalTransplant International
Volume25
Issue number12
DOIs
Publication statusPublished - 2012 Dec

All Science Journal Classification (ASJC) codes

  • Transplantation

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    Jeon, H. J., Kim, Y. J., Kwon, H. Y., Koo, T. Y., Baek, S. H., Kim, H. J., Huh, W. S., Huh, K. H., Kim, M. S., Kim, Y. S., Park, S. K., Ahn, C., & Yang, J. (2012). Impact of parathyroidectomy on allograft outcomes in kidney transplantation. Transplant International, 25(12), 1248-1256. https://doi.org/10.1111/j.1432-2277.2012.01564.x