ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

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