Abstract: FR-PO1162
The Risk of Hypercalcemia After the Kidney Transplantation? Analysis of Cinacalcet Therapy with 10 Years of Follow-Up in a Single Center
Session Information
- Transplantation: Clinical - Post-Transplant Complications
November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Martino, Francesca K., San Bortolo Hospital, Vicenza, Italy
- Tantillo, Ilaria, San Bortolo Hospital, Vicenza, Italy
- Gastaldon, Fiorella, San Bortolo Hospital, Vicenza, Italy
- Ronco, Claudio, University of Padova, IRRIV, San Bortolo Hospital, Vicenza, Italy
Background
The persistence of secondary hyperparathyroidism after kidney transplantation (KT) occasionally manifests itself by hypercalcemia and hypophosphatemia. In patients with KT, Cinacalcet is an off label treatment for hypercalcemia related to hyperparathyroidism. The aim of our study is to evaluate which factors are predictive of hypercalcemia that requires the use of Cinacalcet.
Methods
We retrospectively examined all the patients who received a KT from 2008 and 2018. In each patient we evaluated demographic characteristics and the following parameters: creatinine, hemoglobin, albumin, Calcium, Phosphate, PTH , vitD25OH, and the linked therapies.
T Student, Kruskal Wallis, and Pearson's chi-square tests were used, as appropriate. The regression model was used to evaluate the predictive variables for the use of Cinacalcet.
Results
In a 10-year period 459 KT were performed. Only 9.2% of the patients needed Cinacalcet therapy. Table 1 shows the comparison of the characteristics of those patients who needed Cinacalcet therapy and those who did not. Dead donor transplantation (OR 4.3 p = 0.023), number of KT received (OR 6.8 p <0.0001), PTH levels (OR 1.01 p <0.001), and phosphate levels (OR 0.44.6 p = 0.01) were all independent predictors for Cinacalcet use in multivariable analysis.
Conclusion
Our data show that dead donor transplantation, presence of previous KT, and both PTH and phosphate levels were able to predict Cinacalcet therapy. In these cases we suggest a more careful monitoring of the calcium levels.
| No Cinacalcet | Cinacalcet | p value | |
| Age (years) | 55.8±12.9 | 55.2±12.4 | 0.753 |
| Dead donor transplant (%) | 78.2 | 92.3 | 0.025 |
| Previous transplant (%) | 4.1 | 26.2 | <0.001 |
| Calcium (mg/dl) | 9.2±0.6 | 9.6 | <0.001 |
| Phosphate (mg/dl) | 3 (2.6-3.4) | 2.5 (2.2-2.9) | <0.001 |
| PTH (pg/ml) | 46 (33.2-70) | 70 (59.5-112) | <0.001 |
| Hemoglobin (g/dl) | 12.9±1.8 | 13±1.6 | 0.55 |
| Albumin (g/dl) | 3.6±0.36 | 3.7±0.36 | 0.12 |
| ICN therapy (%) | 99.7 | 97.6 | 0.17 |
| MMF therapy (%) | 82.5 | 85.7 | 0.598 |
| mTOR therapy (%) | 9.8 | 9.5 | 0.949 |
| AZA therapy (%) | 7.9 | 4.7 | 0.463 |
| Cholecalciferol therapy (%) | 48.2 | 40.5 | 0.339 |
| Calcitriol therapy (%) | 16.7 | 2.3 | 0.422 |
| Calcium binders therapy (%) | 0.9 | 0 | 0.524 |
Funding
- Government Support - Non-U.S.