Abstract: TH-PO1050

Mineral Bone Disease after Kidney Transplantation

Session Information

Category: Mineral Disease

  • 1201 Mineral Disease: Ca/Mg/PO4

Authors

  • Miranda, Silvana Maria Carvalho, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Jorge, Ana elisa Souza, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Pereira jr, Gerson Marques, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Souza, Pedro Augusto Macedo, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Alvarenga, Andre Sousa, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Felipe, Carlos rafael Almeida, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
  • Piana, Izabela Lara, Faculdade de Minas Faminas BH, Belo Horizonte, Brazil
Background

Mineral bone disease (MBD) after kidney transplant (KT) is frequent and associated with pre-existing MBD, immunosuppressive therapy and graft function.

Methods

We analyzed the evolution of serum calcium (Ca), phosphorus (P) and parathyroid hormone (PTH) before and after KT from a retropective cohort of 39 KT patients in a Brazilian KT center.

Results

There was a significant reduction of P and PTH after KT, whereas Ca increased significantly (Table 1). At 1 year of KT, 17.9% of patients had hypercalcemia and 17.1%, hypophosphatemia. PTH above the normal range was observed in 68% of patients. Pre-transplant PTH was positively correlated with post-transplant PTH (r = 0.519, p = 0.001) and negatively correlated with post-transplant P (r = -0.450, p = 0.004). There was no correlation between pre-transplant PTH and post-transplant Ca (r = 0.174, p = 0.296) or eGFR (r = -0.035, p = 0.840). Figure 1 shows the positive correlation between post-transplant PTH and Ca; the negative correlation between post-transplant PTH and P. Interestingly, the only variable associated with post-transplant eGFR was pre-transplant P, with a negative correlation (r = -0.326, p = 0.042).

Conclusion

After KT, there were a significant increase in Ca and reduction of PTH and P levels. Post-transplant hyperparathyroidism, hypercalcemia and hypophosphatemia were frequent, and post-KT PTH correlated with Ca and P. Pre-transplant P correlated negatively with eGFR post-trasnplant.

Table 1: Evolution of mineral parameters after kidney transplant
VariablePre-transplant (n=39)Post-transplant (n=39)p
PTH (pg/mL) – median340.891.6<0.0001
P (mg/dL) - mean5.273.02<0.0001
Ca (mg/dL) – median8.689.37<0.0001

Figure1: Linear Regression for mineral parameters