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Abstract: PO0337

Mineral Metabolism Changes in Renal Transplantation

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Ferreira, Ana Carina, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Mendes, Marco, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Silva, Cecilia, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Cotovio, Patrícia, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Aires, Ines, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Navarro, David, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Pereira, Fernando Caeiro, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Salvador, Rute Maria Silva, Nova Medical School, Lisbon, Lisboa, Portugal
  • Correia, Bruna F., Nova Medical School, Lisbon, Lisboa, Portugal
  • Cabral, M. Guadalupe, Nova Medical School, Lisbon, Lisboa, Portugal
  • Nolasco, Fernando E B, Hospital Curry Cabral, Lisboa, Lisboa, Portugal
  • Ferreira, Manuel A., Hospital Curry Cabral, Lisboa, Lisboa, Portugal
Background

Successful renal transplant restores many physiologic abnormalities. The aim of this study was to analyse the evolution of CKD-MBD players [alpha-klotho, fibroblast grow factor (FGF) 23, sclerostin, parathyroid hormone (PTH), bone alkaline phosphatase (bAP), calcitonin, vitamin D (vitD), phosphorus (Pi), Calcium (Ca) and Magnesium (Mg)] pre and post transplantation.

Methods

Prospective cohort study of de novo renal transplanted patients (pts). A inclusion and after 12 months (time 0 and 1) pts performed laboratory evaluation. The difference between values (time1 - time 0) is the delta value. Associations between variables were performed using Wilcoxon matched-pairs test and Spearman correlation test. STATA software was used and p < 0.05 was considered statistically significant.

Results

We recruited 85 pts in 29 months and included 69 pts in the study.
Mean age 50.2±12.4 years, 48 men, 53 caucasian (78.8%), median BMI 24.5 (22.7 – 27.8), median dialysis vintage 55 (42 – 84). We observe a significant reduction on Pi, Mg, PTH, calcitonin, sclerostin, bAP and FGF23. Both Ca and alpha-klotho levels increased, with no significant changes in vitD levels.

With restoring renal health (time 1) and comparing with time 0, PTH maintain the negative correlation with sclerostin (p=0.02) and the positive correlation with FGF23 (p=0.0002); modify the correlation with Pi, becoming a negative correlation instead of positive (p=0.001) and gain new correlations with Ca (p=0.001) and vitD levels (p=0.03). Also, PTH correlated with the delta FGF23 (rho=-0.4, p=0.003) and sclerostin correlated with delta PTH (p=0.01). FGF23 didn’t reveal statistical association with Pi or Ca levels after transplant, contrasting with positive associations in pre transplant (p=0.002, p<0.0001). On the contrary, sclerostin developed a new correlation with Pi (p=0.0004) and a negative correlation with Ca (p=0.01). We didn’t find correlations between these molecules and alpha-klotho.

Conclusion

It seems that sclerostin influences PTH levels and that PTH is the stimulus for the increase or decrease of FGF23 serum levels. Levels of Ca and Pi seemed to be directly influenced by the level of PTH in post transplant, and those minerals seemed to be key factors for sclerostin secretion.