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Impact of parathyroidectomy on allograft outcomes in kidney transplantation

Authors
 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 
Citation
 TRANSPLANT INTERNATIONAL, Vol.25(12) : 1248-1256, 2012 
Journal Title
 TRANSPLANT INTERNATIONAL 
ISSN
 0934-0874 
Issue Date
2012
MeSH
Adult ; Female ; Glomerular Filtration Rate ; Humans ; Hyperparathyroidism/etiology ; Hyperparathyroidism/physiopathology ; Hyperparathyroidism/surgery ; Kidney Transplantation*/physiology ; Male ; Parathyroid Hormone ; Parathyroidectomy* ; Retrospective Studies ; Time Factors ; Transplantation, Homologous ; Treatment Outcome
Keywords
hyperparathyroidism ; kidney transplantation ; parathyroidectomy
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.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1432-2277.2012.01564.x/abstract
DOI
23020185
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91947
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