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Abstract: FR-PO1160

Bone Turnover Markers Are Associated with Hypocalcemia Immediately After Renal Transplantation

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kong, Weiwei, First hospital of Zhejiang University, Hangzhou, China
  • Chen, Jianghua, Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, ZheJiang, China
  • Huang, Hongfeng, Kidney Disease Center, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, Hangzhou, China
Background

Bone and mineral disorders occur commonly after renal transplantation (RTX). Serum calcium levels decreased after RTX and gradually reach calcium homeostasis. Hypocalcemia immediately after RTX may influence QTc interval and myocardial contractility, thus it is a life-threatening phenomenon after RTX. Bone turnover markers (BTMs) are markers reflect the bone turnover stage and bone and mineral disorders. Whether BTMs can predict the occurrence of hypocalcemia after RTX has not been reported.

Methods

A total of 101 patients receiving ABO compatible living donor renal transplantation were assessed. General patient information, kidney function and calcium metabolism indexes were measured before transplantation. Calcium metabolism indexes included calcium, phosphorus, parathyroid hormone (PTH), 25-dihydroxyvitamin D (25(OH)D3) and BTMs. BTMs included procollagen type I N-terminal propeptide (PINP), N-terminal mid-molecule fragment osteocalcin (N-MID) and β-C-telopeptide of type I collagen (β-CTX). The patients were divided into two groups dependent on post-transplantation calcium levels, non-hypocalcemia group and hypocalcemia group. The prediction value for hypocalcemia were evaluated by concordance index (c-index), akaike information criterion (AIC) and cayesian information criterion (BIC) methods.

Results

General patient information, kidney function and calcium metabolism indexes were compared between non-hypocalcemia group and hypocalcemia group. Age, dialysis type, serum calcium levels, PTH, 25(OH)D3 and BTM levels showed differences between non-hypocalcemia group and hypocalcemia group. Then correlation analysis showed calcium levels after RTX showed positive correlations with serum PTH, 25(OH)D3, PINP, N-MID and β-CTX amounts. Further utilizing multi-regression selected risk factors to established basic model equation (AIC=126.85 and BIC=134.69; c-index 0.78). Then we added PTH, 25(OH)D3, N-MID and PINP to basic model respectively and found no influence on predictive ability. Final inclusion of β-CTX, one of BTMs, to basic model improved the predictive performance significantly (AIC=113.44 and BIC=123.9; c-index 0.83).

Conclusion

Low levels of BTMs were associated with hypercalcemia after RTX. To predict the occurrence of hypocalcemia, β-CTX, one of BTMs, could improve the predictive ability.