Determinants of hyperparathyroidism in children after kidney transplantation
© 2024 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd..
INTRODUCTION: Hyperparathyroidism (HPT) can contribute to metabolic bone disease following kidney transplantation. We evaluated post-transplant trends in intact parathyroid hormone (iPTH) and determined predictors of HPT in pediatric kidney transplant (KTx) recipients.
METHODS: In this single-center study, retrospective data were collected on 88 children from 2013 to 2019. Data collected included dialysis vintage, biochemical parameters, post-transplant trends in iPTH, 25(OH)Vitamin D levels and estimated glomerular filtration rate (eGFR ml/min/1.73 m2 ). Pre-transplant treatment for HPT was quantified with a Treatment Burden score (TB, score range: 0-100). After log-transforming skewed variables (iPTH and eGFR), multivariable linear regression was performed to determine predictors of log {iPTH} at 6 and 36 months (mo) post-transplant.
RESULTS: Median age was 12.8 (range: 1.9-20.5) years, and dialysis vintage was 11.2 (range: 0.0-112.9) months. The majority were of Hispanic and African Ancestry (77.3%). Median post-transplant iPTH was 69.5 (range: 1.8-306.8) pg/ml at 6 mo with a gradual downward trend to 59.0 (range: 28.0-445.0) pg/ml at 36 mo. Significant multivariable predictors of higher log {iPTH} post-transplant included longer dialysis vintage, higher TB, and lower log{eGFR} at 6 mo, and higher TB, lower log{eGFR}, and deceased donor transplant at 36 mo.
CONCLUSIONS: Recognition of risk factors for HPT and monitoring iPTH post-transplant may facilitate timely interventions to mitigate cardiovascular and bone disease in pediatric KTx recipients.
KEY MESSAGE: Describe serial trends in intact PTH after kidney transplantation. Pre- and post-transplant factors that contribute to persistence or re-occurrence of hyperparathyroidism after kidney transplantation in children include longer dialysis vintage, high pre-transplant treatment burden and decreased post-transplant GFR. Recognition of these factors, and monitoring intact PTH after kidney transplantation, could facilitate timely interventions to mitigate cardiovascular and bone disease in children.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2024 |
---|---|
Erschienen: |
2024 |
Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
---|---|
Enthalten in: |
Clinical transplantation - 38(2024), 3 vom: 19. März, Seite e15284 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Glaberson, Wendy [VerfasserIn] |
---|
Links: |
---|
Themen: |
Hyperparathyroidism |
---|
Anmerkungen: |
Date Completed 15.03.2024 Date Revised 18.04.2024 published: Print Citation Status MEDLINE |
---|
doi: |
10.1111/ctr.15284 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM369730119 |
---|
LEADER | 01000caa a22002652 4500 | ||
---|---|---|---|
001 | NLM369730119 | ||
003 | DE-627 | ||
005 | 20240419232436.0 | ||
007 | cr uuu---uuuuu | ||
008 | 240315s2024 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1111/ctr.15284 |2 doi | |
028 | 5 | 2 | |a pubmed24n1380.xml |
035 | |a (DE-627)NLM369730119 | ||
035 | |a (NLM)38483311 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Glaberson, Wendy |e verfasserin |4 aut | |
245 | 1 | 0 | |a Determinants of hyperparathyroidism in children after kidney transplantation |
264 | 1 | |c 2024 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 15.03.2024 | ||
500 | |a Date Revised 18.04.2024 | ||
500 | |a published: Print | ||
500 | |a Citation Status MEDLINE | ||
520 | |a © 2024 The Authors. Clinical Transplantation published by John Wiley & Sons Ltd. | ||
520 | |a INTRODUCTION: Hyperparathyroidism (HPT) can contribute to metabolic bone disease following kidney transplantation. We evaluated post-transplant trends in intact parathyroid hormone (iPTH) and determined predictors of HPT in pediatric kidney transplant (KTx) recipients | ||
520 | |a METHODS: In this single-center study, retrospective data were collected on 88 children from 2013 to 2019. Data collected included dialysis vintage, biochemical parameters, post-transplant trends in iPTH, 25(OH)Vitamin D levels and estimated glomerular filtration rate (eGFR ml/min/1.73 m2 ). Pre-transplant treatment for HPT was quantified with a Treatment Burden score (TB, score range: 0-100). After log-transforming skewed variables (iPTH and eGFR), multivariable linear regression was performed to determine predictors of log {iPTH} at 6 and 36 months (mo) post-transplant | ||
520 | |a RESULTS: Median age was 12.8 (range: 1.9-20.5) years, and dialysis vintage was 11.2 (range: 0.0-112.9) months. The majority were of Hispanic and African Ancestry (77.3%). Median post-transplant iPTH was 69.5 (range: 1.8-306.8) pg/ml at 6 mo with a gradual downward trend to 59.0 (range: 28.0-445.0) pg/ml at 36 mo. Significant multivariable predictors of higher log {iPTH} post-transplant included longer dialysis vintage, higher TB, and lower log{eGFR} at 6 mo, and higher TB, lower log{eGFR}, and deceased donor transplant at 36 mo | ||
520 | |a CONCLUSIONS: Recognition of risk factors for HPT and monitoring iPTH post-transplant may facilitate timely interventions to mitigate cardiovascular and bone disease in pediatric KTx recipients | ||
520 | |a KEY MESSAGE: Describe serial trends in intact PTH after kidney transplantation. Pre- and post-transplant factors that contribute to persistence or re-occurrence of hyperparathyroidism after kidney transplantation in children include longer dialysis vintage, high pre-transplant treatment burden and decreased post-transplant GFR. Recognition of these factors, and monitoring intact PTH after kidney transplantation, could facilitate timely interventions to mitigate cardiovascular and bone disease in children | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a hyperparathyroidism | |
650 | 4 | |a kidney transplant | |
650 | 4 | |a pediatric | |
650 | 4 | |a treatment burden | |
650 | 7 | |a Parathyroid Hormone |2 NLM | |
700 | 1 | |a Seeherunvong, Wacharee |e verfasserin |4 aut | |
700 | 1 | |a Gaynor, Jeffrey J |e verfasserin |4 aut | |
700 | 1 | |a Katsoufis, Chryso |e verfasserin |4 aut | |
700 | 1 | |a Defreitas, Marissa |e verfasserin |4 aut | |
700 | 1 | |a Bao, Yong |e verfasserin |4 aut | |
700 | 1 | |a Freundlich, Michael |e verfasserin |4 aut | |
700 | 1 | |a Ciancio, Gaetano |e verfasserin |4 aut | |
700 | 1 | |a Abitbol, Carolyn |e verfasserin |4 aut | |
700 | 1 | |a Chandar, Jayanthi |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t Clinical transplantation |d 1987 |g 38(2024), 3 vom: 19. März, Seite e15284 |w (DE-627)NLM07493306X |x 1399-0012 |7 nnns |
773 | 1 | 8 | |g volume:38 |g year:2024 |g number:3 |g day:19 |g month:03 |g pages:e15284 |
856 | 4 | 0 | |u http://dx.doi.org/10.1111/ctr.15284 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 38 |j 2024 |e 3 |b 19 |c 03 |h e15284 |