Abstract: TH-PO1050
Mineral Bone Disease after Kidney Transplantation
Session Information
- Mineral Disease: Ca/Mg/PO4
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
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
| Variable | Pre-transplant (n=39) | Post-transplant (n=39) | p |
| PTH (pg/mL) – median | 340.8 | 91.6 | <0.0001 |
| P (mg/dL) - mean | 5.27 | 3.02 | <0.0001 |
| Ca (mg/dL) – median | 8.68 | 9.37 | <0.0001 |
Figure1: Linear Regression for mineral parameters