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Hyperparathyroidism and increased fractional excretion of phosphate predict allograft loss in long-term kidney transplant recipients
- Source :
- Clinical and Experimental Nephrology. 21:926-931
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- After kidney transplantation, fibroblast growth factor-23 (FGF-23) normally returns to baseline within 1 year whereas hyperparathyroidism persists in most kidney transplant (KT) recipients. As a result, serum phosphate remains relatively low in association with increased serum calcium and urinary phosphate excretion when compared to chronic kidney disease patients. The relationship between mineral metabolism and outcomes in long-term KT recipients has not been extensively studied. This study investigated whether the alteration in mineral metabolism influenced graft survival in long-term KT recipients.This study included 273 KT recipients after 1 year of transplantation. Mineral parameters were obtained at the time of enrolment and patients were followed prospectively for an average of 71 months.Graft loss (death-censored) occurred in 41 (15%) patients. In univariate analysis, deceased donor transplantation, decreased serum albumin and estimated glomerular filtration rate, increased serum phosphate, parathyroid hormone (PTH), FGF-23 and fractional excretion of phosphate (FePi) predicted future allograft loss. After adjustments for cardiovascular disease risk factors, donor type, dialysis vintage, serum albumin and allograft function, only increased PTH and FePi remained associated with the outcome. Relationships between increased serum phosphate and FGF-23 with graft survival were lost after adjustments. Adjusted survival curves revealed the association between PTH90 pg/mL and FePi20% with worse graft survival.Hyperparathyroidism and increased FePi predicted allograft loss in long-term KT recipients.
- Subjects :
- Adult
Male
Nephrology
medicine.medical_specialty
Time Factors
Hypophosphatemia
Physiology
Urinary system
030232 urology & nephrology
030204 cardiovascular system & hematology
Kidney
Phosphates
Excretion
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Renal Dialysis
Risk Factors
Physiology (medical)
Internal medicine
medicine
Vitamin D and neurology
Humans
Prospective Studies
Hypophosphatemia, Familial
Kidney transplantation
Hyperparathyroidism
business.industry
Graft Survival
Middle Aged
Allografts
medicine.disease
Phosphate
Kidney Transplantation
Fibroblast Growth Factor-23
Renal Elimination
Treatment Outcome
Endocrinology
chemistry
Female
business
Glomerular Filtration Rate
Kidney disease
Subjects
Details
- ISSN :
- 14377799 and 13421751
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- Clinical and Experimental Nephrology
- Accession number :
- edsair.doi.dedup.....fa56ddf3080ae94002d1a72c00d1a1c8