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Kidney Week

Abstract: TH-PO859

Association Between Hemoglobin Levels and Hypercalcemia due to Persistent Hyperparathyroidism in Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Cojuc, Gabriel, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Gindl-Bracho, Alfonso, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Albarran Munoz, Sophia, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Linares Perez, Cielo Estefanny, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Pichardo, Nathalie D., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Marino-Vazquez, Lluvia A., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Morales-Buenrostro, Luis E., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Ramirez-Sandoval, Juan Carlos, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background

Hypercalcemia has emerged as a potential non-traditional factor associated with erythrocytosis following transplantation. We hypothesized that hypercalcemia due to persistent hyperparathyroidism is positively correlated with hemoglobin levels in kidney transplant recipients (KTRs).

Methods

We conducted a prospective cohort study investigating the trajectory of hemoglobin in KTRs with and without persistent hypercalcemia (free calcium >5.2 mg/dL in ≥80% of measures). We performed mixed model analyses adjusting for potential confounders.

Results

We included 385 subjects. Persistent hypercalcemia was present in 66% (56% male, median age 36 [IQR 28-48] years, median follow-up 4.1 [IQR 1-8.2] years). KTRs with hypercalcemia due to persistent hyperparathyroidism had a mean increase in hemoglobin levels of 0.76 g/dL/year (95% CI 0.45-1.08) compared to KTRs without hypercalcemia, 0.80 (95% CI 0.32-1.27) g/dL/year for males and 0.36 (95% CI 0.16-1.08) g/dL/year for females. Hypercalcemia was significantly associated with post-transplant erythrocytosis according to the WHO (47% vs. 24%, OR 2.8, 95% CI 1.8-4.4) and altitude-adjusted criteria (22% vs. 10%, OR 2.5, 95% CI 1.2-4.5). The significance of the effect of hypercalcemia on hemoglobin levels was consistent after adjusting for potential confounders.

Conclusion

Hypercalcemia due to persistent hyperparathyroidism after kidney transplantation was significantly associated with higher hemoglobin levels and an increased likelihood of developing post-transplant erythrocytosis.

The trajectory of hemoglobin, total calcium, and free calcium in KTRs with and without persistent hypercalcemia.