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Pihlstrøm, H; Dahle, DO; Mjøen, G; Pilz, S; März, W; Abedini, S; Holme, I; Fellström, B; Jardine, AG; Holdaas, H.
Increased risk of all-cause mortality and renal graft loss in stable renal transplant recipients with hyperparathyroidism.
Transplantation. 2015; 99(2):351-359 [OPEN ACCESS]
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Authors Med Uni Graz:
Maerz Winfried
Pilz Stefan
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Abstract:
Hyperparathyroidism is reported in 10% to 66% of renal transplant recipients (RTR). The influence of persisting hyperparathyroidism on long-term clinical outcomes in RTR has not been examined in a large prospective study. We investigated the association between baseline parathyroid hormone (PTH) levels and major cardiovascular events, renal graft loss, and all-cause mortality by Cox Proportional Hazard survival analyses in 1840 stable RTR derived from the Assessment of LEscol in Renal Transplantation trial. Patients were recruited in a mean of 5.1 years after transplantation, and follow-up time was 6 to 7 years. Significant associations between PTH and all 3 outcomes were found in univariate analyses. When adjusting for a range of plausible confounders, including measures of renal function and serum mineral levels, PTH remained significantly associated with all-cause mortality (4% increased risk per 10 units; P=0.004), and with graft loss (6% increased risk per 10 units; P<0.001), but not with major cardiovascular events. Parathyroid hormone above the upper limit of normal (65 pg/mL) indicated a 46% (P=0.006) higher risk of death and an 85% higher risk of graft loss (P<0.001) compared with low/normal values. Hyperparathyroidism is an independent, potentially remediable, risk factor for renal graft loss and all-cause mortality in RTR.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Biomarkers - blood
Cardiovascular Diseases - etiology
Cardiovascular Diseases - mortality
Cause of Death -
Chi-Square Distribution -
Female -
Graft Survival -
Humans -
Hyperparathyroidism - blood
Hyperparathyroidism - diagnosis
Hyperparathyroidism - etiology
Hyperparathyroidism - mortality
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - diagnosis
Kidney Failure, Chronic - mortality
Kidney Failure, Chronic - surgery
Kidney Transplantation - adverse effects
Kidney Transplantation - mortality
Linear Models -
Male -
Middle Aged -
Multivariate Analysis -
Parathyroid Hormone - blood
Proportional Hazards Models -
Randomized Controlled Trials as Topic -
Retrospective Studies -
Risk Factors -
Time Factors -
Treatment Outcome -
Up-Regulation -

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