P1429EVALUATION OF PARATHYROIDECTOMY IN PERSISTENT HYPERARATHYROIDISM AFTER RENAL TRANSPLANTATION: A SINGLE-CENTER RETROSPECTIVE STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ping Zhang ◽  
Hulin Lu ◽  
Jianghua Chen
Keyword(s):  
Alkaline Phosphatase ◽  
Retrospective Study ◽  
Renal Transplantation ◽  
Serum Creatinine ◽  
Serum Calcium ◽  
Renal Allograft ◽  
Serum Phosphorus ◽  
Single Center ◽  
High Calcium ◽  
Allograft Function

Abstract Background and Aims To investigate the efficacy of parathyroidectomy (PTX) in the treatment of persistent hyperparathyroidism (PHPT) after renal transplantation and the effect of PTX on renal allograft function. Method This single-center retrospective study enrolled 31 patients who underwent PTX for the treatment of PHPT after renal transplantation in the Kidney Disease Center of the First Affiliated Hospital of Zhejiang University from May 2010 to Oct. 2018. The changes of serum calcium, serum phosphorus, alkaline phosphatase, parathyroid hormone(PTH), serum creatinine, and estimated glomerular filtration rate (eGFR) in the preoperative and postoperative periods (1w, 1m, 3m, 6m,12m) were compared. The operative successful rate (12 m) and postoperative complications were calculated. Results The serum calcium before PTX was (2.78±0.18) mmol/L, which decreased significantly to (2.19±0.34) mmol/L at 1 week postoperatively (P<0.01). The serum phosphorus before PTX was (0.76±0.16) mmol/L, which decreased significantly to (0.97±0.26) mmol/L at 1 week postoperatively (P<0.01). The PTH before PTX was (276.00±200.60) pg/mL, which decreased significantly to (46.62±104.36) pg/mL at 1 week postoperatively (P<0.01). The alkaline phosphatase before PTX was (261.59±236.95) U/L, which decreased significantly to (154.90±117.37) U/L at 3 months postoperatively (P<0.01). No significant difference was found in postoperative serum creatinine or eGFR levels compared with the baseline. The operative successful rate was 90.3% at 12 months postoperatively. The incidence rates of postoperative transient hypocalcemia, persistent hypoparathyroidism, and hoarseness were 35.5%, 3.2% and 3.2% respectively. No persistent hypocalcemia, incision hemorrhage, incision infection, or surgery-related death happened. Conclusion PTX can quickly and effectively alleviate high calcium, low phosphorus, high PTH and high alkaline phosphatase after renal transplantation. PTX is effective and safe in the treatment of PHPT after renal transplantation, and has no effect on renal allograft function.

AN EVALUATION OF VESICAL URODYNAMICS BEFORE RENAL TRANSPLANTATION AND ITS EFFECT ON RENAL ALLOGRAFT FUNCTION AND SURVIVAL

1994 ◽  
Vol 57 (10) ◽  
pp. 1455-1457 ◽  
Author(s):  
S. Habib Kashi ◽  
KAMIL S. WYNNE ◽  
SAMI A. SADEK ◽  
J. Peter A. Lodge
Keyword(s):  
Renal Transplantation ◽  
Renal Allograft ◽  
Allograft Function

scholarly journals The association of two single-nucleotide polymorphisms of the FOXP3 gene (rs3761548 and rs3761547) with renal allograft function and survival in kidney transplant recipients

2020 ◽  
Vol 7 (2) ◽  
pp. e21-e21
Author(s):  
Vahideh Ebrahimzadeh Attari ◽  
Seyed Sadroddin Rasi Hashemi ◽  
Solmaz Oloufi ◽  
Leili Aghebati Maleki ◽  
Dariush Shanehbandi ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Kidney Transplant ◽  
Creatinine Level ◽  
Kidney Function ◽  
Renal Allograft ◽  
Regulatory Protein ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Allograft Function

Introduction: The FOXP3 protein is an immune regulatory protein that specifically maintains the function and differentiation of regulatory T cells (Tregs) and prevents autoimmunity. Variations in FOXP3 gene may alter its function and also the immune response. Objectives: The present study was conducted to investigate the association of the FOXP3 gene polymorphisms -3499 A/G and -3279 A/C with renal allograft function and survival in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 150 eligible kidney transplant recipients were evaluated. Kidney function was evaluated at three- and five-year post-transplant using serum creatinine level and glomerular filtration rate as indicators. Genotyping of the study participants was performed using the PCR– restriction fragment length polymorphism method. Results: The frequencies of AA, AG, and GG genotypes of the -3499 A/G polymorphism were 62.42%, 29.53%, and 8.05%, respectively. For the -3279 A/C polymorphism, the frequencies of the AA, AC, and CC genotypes were 21.33%, 32%, and 46.67%, respectively. The mean ± SD of serum creatinine level, three and five years after transplantation were 1.70 ± 1.58 and 1.87 ± 1.94, respectively. Serum creatinine level and kidney function did not show any significant association with these polymorphisms. Conclusion: In the present study, only 10% of participants experienced episodes of severe kidney dysfunction and we did not find any significant association between kidney function and the subjects’ genotypes. Further epidemiologic studies with greater sample sizes may be needed to clarify this association.

Albumin and beta 2-microglobulin radioimmunoassays applied to monitoring of renal-allograft function and in differentiating glomerular and tubular diseases.

1981 ◽  
Vol 27 (5) ◽  
pp. 709-713 ◽  
Author(s):  
J Woo ◽  
M Floyd ◽  
D C Cannon
Keyword(s):  
Serum Creatinine ◽  
Renal Damage ◽  
Renal Allograft ◽  
Acute Allograft Rejection ◽  
Tubular Proteinuria ◽  
Group I ◽  
Allograft Function ◽  
Beta 2 ◽  
Group Ii ◽  
Beta 2 Microglobulin

Abstract Blood and urine were samples daily from 11 renal-allograft recipients from one to six weeks after the transplant. Clearances of both albumin (Calb) and beta2-microglobulin (C beta 2 mu) were significantly increased in all 11 patients. Five patients (Group I) with acute allograft rejection showed markedly increased Calb and moderately increased C beta 2 mu, concurrent with decreased creatinine clearance (CCr). Five other patients (Group II) with no evidence of rejection demonstrated episodes of grossly increased C beta 2 mu with minimally increased but stable Calb and normal CCr. One patient had no evidence of rejection nor indications of glomerular or tubular proteinuria. While changes in serum beta 2-microglobulin concentration closely paralleled those of serum creatinine in the Group II patients, the results diverged in the Group I patients because the increase in serum beta 2-microglobulin exceeded that of serum creatinine and preceded the increased in creatinine by one to five days, suggesting that measurement of serum beta 2-microglobulin might afford earlier indication of the nature and extent of renal damage in the allograft recipients.

scholarly journals SAT-356 Reversible Suppression of Serum 1,25-Dihydroxyvitamin D in Williams Syndrome

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Michael Yuri Torchinsky ◽  
Eric Bugaieski
Keyword(s):  
Alkaline Phosphatase ◽  
Williams Syndrome ◽  
Serum Calcium ◽  
Calcium Content ◽  
Dietary Calcium ◽  
Dietary Calcium Intake ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
High Calcium ◽  
Medullary Nephrocalcinosis

Abstract Background: Hypercalcemia has been reported in 5% to 50% of patients with Williams syndrome; however, observations about the role of 1,25-dihydroxyvitamin D in hypercalcemia related to Williams syndrome have been contradictory. Objective: The objective was to investigate the mineral metabolism in an 11-month-old patient with Williams-Beuren syndrome who had hypercalcemia, hypercalciuria and nephrocalcinosis. Methods: We reviewed test results in an 11-month-old infant with Williams syndrome who developed hypercalcemia following excessive dietary calcium intake that was two to three times higher than recommended for age because he continued receiving a premature formula with high calcium content from birth. Results: Our patient presented with feeding difficulties, daily vomiting, weight loss, and constipation. He had serum total calcium 14.8 mg/dL, phosphorus 4.0 mg/dL, PTH <4 pg/mL, 1,25-dihydroxyvitamin D <8 pg/mL, 25-hydroxyvitamin D 29 ng/mL, PTH-related peptide 3.7 pmoL/L (expected <4.2), alkaline phosphatase 118 U/L, beta-crosslaps 1257 pg/mL, and urinary calcium/creatinine ratio 1.19. XR Skeletal Survey revealed increased bone density in the metaphyseal regions, in particular, above the knee, distal radius and ulna that may result from hypercalcemia; no evidence of rickets, osteoporosis or congenital osteodystrophy was seen. Renal ultrasound revealed increased echogenicity of the renal medullary pyramids consistent with medullary nephrocalcinosis. Hypercalcemia and hypercalciuria were initially treated with IV fluids and Furosemide IV, and resolved only after Pamidronate 0.5 mg/kg/dose IV x 2 doses. After serum calcium normalized, the patient’s symptoms resolved, PTH recovered to 18 pg/mL (expected 10 - 65), and 1,25-dihydroxyvitamin D increased to 27 pg/mL (expected 24 - 86). Chromosomal micro-array analysis showed a 1.9 megabase deletion at 7q11.23 that overlapped the Williams syndrome critical region including the ELN gene, consistent with diagnosis of Williams syndrome. Serum calcium remained normal with dietary calcium restriction using a low-calcium formula and complementary foods. Conclusions: PTH-independent hypercalcemia in our patient with Williams syndrome was due to calcium overload resulting from dietary calcium excess in addition to possibly enhanced intestinal calcium absorption. Serum 1,25-dihydroxyvitamin D was undetectable and returned to normal only with resumption of PTH secretion required for its synthesis after hypercalcemia resolved. The balance between bone formation and resorption was shifted to resorption possibly to remove skeletal calcium excess, based on normal alkaline phosphatase (marker of osteoblast activity) and high collagen beta-crosslaps (marker of osteoclast activity). A premature formula with high calcium content should be switched to a full-term formula when risk for rickets of prematurity clears.

Vitamin D Status as a Predictor of Postoperative Hypocalcemia after Thyroidectomy

2020 ◽  
Vol 163 (3) ◽  
pp. 501-507
Author(s):  
Samuel J. Rubin ◽  
Jong H. Park ◽  
Elizabeth N. Pearce ◽  
Michael F. Holick ◽  
David McAneny ◽  
...  
Keyword(s):  
Vitamin D ◽  
Retrospective Study ◽  
Serum Calcium ◽  
Study Design ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Care Hospital ◽  
Single Center ◽  
Postoperative Hypocalcemia ◽  
Vitamin D Levels

Objective To determine whether perioperative vitamin D levels are predictive of postoperative hypocalcemia in patients receiving thyroidectomy. Study Design Single center retrospective study. Subjects and Methods This study included all patients receiving total or completion thyroidectomy between January 2007 and March 2017 at a single tertiary care hospital. 25-Hydroxyvitamin D (25[OH]D) levels were measured within 42 days prior to surgery or 1 day postoperatively. Hypocalcemia was defined as an adjusted serum calcium <8.0 mg/dL (based on albumin levels) or symptomatic hypocalcemia. Univariate analysis was performed with a 2-sample t test and chi-square test, while multivariate analysis was performed with logistic regression analysis to determine whether perioperative 25(OH)D level is a predictor of postoperative hypocalcemia. Results A total of 517 subjects were included in the study, 15.7% (n = 81) of whom experienced postoperative hypocalcemia with a mean ± SD serum calcium level of 7.6 ± 0.5 mg/dL as compared with 8.9 ± 0.5 mg/dL in the normocalcemic population ( P < .01). The mean 25(OH)D level for patients with hypocalcemia was 24.4 ± 12.0 ng/mL as compared with 27.5 ± 12.2 ng/mL in patients with normocalcemia ( P = .038). Subjects who were hypocalcemic experienced a significantly longer hospital stay (2.9 ± 2.5 vs 1.4 ± 1.1 days, P < .01). After adjusting for preoperative calcium, age, and performance of a neck dissection, subjects with a 25(OH)D level <30 ng/mL were significantly associated with postoperative hypocalcemia (odds ratio, 1.9; P = .041; 95% CI, 1.0-3.3). Conclusion Using a single-center retrospective study design, we demonstrated that 25(OH)D level is a significant predictor of postoperative hypocalcemia after thyroidectomy.

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