Risk factors for persistent hyperparathyroidism in children with stable renal function after kidney transplantation

Abstract Background and Aims T cell immunoglobulin and mucin domain (Tim-3) and its ligand, galectin-9 (Gal-9), play an important role in immune regulation. Serum soluble Tim-3 (sTim-3) and Gal-9 (sGal-9) were observed to be correlated with renal function after kidney transplantation in our previous study, but whether these two could predict the adverse outcomes after transplantation is unknown. Method 91 recipients receiving kidney transplantation were enrolled in this cohort study. 20 of all recipients suffered composite outcomes after kidney transplantation within two years. 71 recipients had stable renal function during this period. The expressions of sTim-3 and sGal-9 before and one month after transplantation were measured by ELISA. Results The level of sTim-3 before transplantation was significantly higher in recipients with stable renal function than composite outcomes (Median: range, 2275: 840-4236 pg/ml vs 1589: 353-3094 pg/ml, P=0.002, shown in Figure 1). The level of sGal-9 after transplantation was significantly lower in stable group than composite outcome group (Median: range, 4869: 1418-13080 pg/ml vs 6852: 4128-10760 pg/ml, P=0.003, shown in Figure 1). Area under curve (AUC) of sTim-3 before transplantation was 0.737 (P=0.002, shown in Figure 2) through the analysis of receiver operating characteristic curve (ROC curve). AUC of sGal-9 after transplantation was 0.751 (P=0.003, shown in Figure 2). After survival analysis, the percentage of recipients free from composite outcomes was significantly lower in patients with low level of sTim-3 than high sTim3 (P<0.0001, shown in Figure 3), so was in patients with high sGal-9 than low sGal-9 (P=0.0004, shown in Figure 3). Conclusion Serum sTim-3 and sGal-9 could predict the adverse outcomes within two years after kidney transplantation.

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Biochemical Characteristics of Bone Mineral Metabolism before and throughout the First Year after Kidney Transplantation, Persistent Hyperparathyroidism, and Risk Factors in a Latin Population

International Journal of Endocrinology ◽

10.1155/2020/6913506 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Lourdes Balcázar-Hernández ◽

Guadalupe Vargas-Ortega ◽

Baldomero González-Virla ◽

Martha Cruz-López ◽

Raúl Rodríguez-Gómez ◽

...

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Kidney Transplant ◽

Bone Mineral ◽

Mineral Metabolism ◽

Hypovitaminosis D ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Bone Mineral Metabolism ◽

Persistent Hyperparathyroidism

Bone mineral metabolism disease, which included persistent hyperparathyroidism, is common after successful kidney transplantation (KT) and is related with negative outcomes in kidney transplant recipients. There is a lack of information about bone mineral metabolism, persistent hyperparathyroidism, and its risk factors in Latin kidney transplant recipients (KTRs). Material and Methods: A retrospective study was conducted in 74 patients aged 18–50 years with evolution of 12 months after KT and estimated glomerular filtration rate (eGFR) >60 ml/min; biochemical data of bone mineral metabolism before and at 1, 3, 6, and 12 months of KT were registered. Results. Age was 33 (IQR 27–37) years; 54% (n = 40) were men. Before KT, all patients had hyperparathyroidism, 40% (n = 30) hypocalcemia, 86% (n = 64) hyperphosphatemia, and 42% (n = 31) hyperphosphatasemia. After KT, an increase of calcium and a diminution of PTH, phosphorus, and alkaline phosphatase were corroborated (p=0.001). All patients had hypovitaminosis D (deficiency: 91% (n = 67); insufficiency: 9% (n = 7)); 40% (n = 30) had persistent hyperparathyroidism at 12 months. Hyperphosphatasemia before KT (OR = 4.17 (95% CI: 1.21–14.44); p=0.04), hyperparathyroidism at 6 months (OR = 1.84 (95% CI; 1.67–2.06); p=0.02), hypovitaminosis D at 6 months (OR = 3.94 (95% CI: 1.86–17.9); p=0.01), and hyperphosphatasemia at 6 months (OR = 1.47 (95% CI: 1.07–2.86); p=0.03) were risk factors for persistent hyperparathyroidism at 12 months after KT. Conclusion. Persistent hyperparathyroidism at 6 months, hypovitaminosis D, and hyperphosphatasemia are risk factors for persistent hyperparathyroidism at 1 year of KT in Latin population.

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Risk factors associated with the deterioration of renal function after kidney transplantation

Kidney International ◽

10.1111/j.1523-1755.2005.09921.x ◽

2005 ◽

Vol 68 ◽

pp. S113-S117 ◽

Cited By ~ 18

Author(s):

Daniel Serón ◽

Xavier Fulladosa ◽

Francesc Moreso

Keyword(s):

Risk Factors ◽

Renal Function ◽

Kidney Transplantation ◽

Factors Associated

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Incidence and Risk Factors of Persistent Hyperparathyroidism After Kidney Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2016.10.011 ◽

2017 ◽

Vol 49 (1) ◽

pp. 53-56 ◽

Cited By ~ 9

Author(s):

K. Nakai ◽

H. Fujii ◽

T. Ishimura ◽

M. Fujisawa ◽

S. Nishi

Keyword(s):

Risk Factors ◽

Kidney Transplantation ◽

Persistent Hyperparathyroidism

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The stiffness of transplanted kidneys changes with time after renal transplantation

Acta Radiologica ◽

10.1177/02841851211030770 ◽

2021 ◽

pp. 028418512110307

Author(s):

Shaona Chen ◽

Jin Li ◽

Bidan Zeng ◽

Zhimin Zhu ◽

Yanhua Luo ◽

...

Keyword(s):

Renal Function ◽

Kidney Transplantation ◽

Renal Transplantation ◽

Kidney Disease ◽

The United States ◽

Renal Transplant Recipients ◽

Scientific Review ◽

Transplanted Kidney ◽

Stable Renal Function ◽

Transplanted Kidneys

Background Kidney transplantation is one of the most effective ways to treat end-stage kidney disease. However, 5000 renal transplant recipients start or restart dialysis because of chronic allograft nephropathy (CAN) every year in the United States. Detecting changes in the stiffness of transplanted kidneys can help diagnose transplanted kidney disease. Purpose To explore changes in the stiffness of transplanted kidneys after renal transplantation using shear wave elastography (SWE). Material and Methods This study conducted consecutive follow-up observations on 10 patients after kidney transplantation. SWE examination was performed in the first week, second week, first month, second month, third month, fourth month, fifth month, and sixth month after surgery. This study also analyzed the graft stiffness of 86 patients with stable renal function recovery one month after surgery. Results The results show that there is a change in the stiffness of the transplanted kidney over time after renal transplantation. It decreases rapidly within one month after renal transplantation and tends to be stable after one month. The mean renal cortical and pyramidal stiffness of patients with stable renal function were 28.48 ± 4.27 kPa and 21.97 ± 3.90 kPa, respectively. Conclusion Consecutive stiffness measurement of transplanted kidneys is an effective method for monitoring the function of transplanted kidneys. According to the change in transplanted kidney stiffness, we can designate a more scientific review plan to determine the functional status of the transplanted kidney.

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