Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function

Autor:	Inger Hjørdis Bleskestad, Torbjørn Leivestad, Lasse G. Gøransson, Harald Bergrem, Anders Hartmann
Rok vydání:	2014
Předmět:	Graft Rejection Male medicine.medical_specialty medicine.medical_treatment Urology Renal function Kidney Function Tests Postoperative Complications Risk Factors Interquartile range Chronic kidney disease-mineral and bone disorder Internal medicine medicine Humans Registries Kidney transplantation Dialysis Retrospective Studies Transplantation business.industry Graft Survival Middle Aged Prognosis medicine.disease Kidney Transplantation Survival Rate Endocrinology Quartile Cardiovascular Diseases Parathyroid Hormone Kidney Failure Chronic Calcium Female Secondary hyperparathyroidism business Biomarkers Follow-Up Studies Glomerular Filtration Rate
Zdroj:	Clinical Transplantation. 28:479-486
ISSN:	0902-0063
Popis:	Background The aim of the study was to investigate whether serum levels of intact parathyroid hormone (iPTH) are associated with an increased risk of cardiovascular events, graft loss, or mortality in kidney transplant patients with optimal transplant function. Methods From the Norwegian Renal Registry, we identified 522 patients who received a first kidney transplant from 2001 to 2008 with optimal transplant function defined as an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, more than one yr after transplantation. Cox's proportional hazard models were used to assess the association between iPTH measured 10 wk after transplantation and the composite endpoint. The estimates were adjusted for age, gender, serum calcium, serum phosphate, diabetes mellitus, cardiovascular disease, and time on dialysis prior to transplantation. Results Median follow-up time was 3.9 yr (interquartile range, IQR: 2.0–6.0 yr). Patients in the third iPTH quartile (9.3–14.4 pM) had the lowest risk for reaching the composite endpoint. Patients in the fourth iPTH quartile (>14.4 pM) had an increased risk compared to those in the third quartile (HR: 2.60, 95% CI: 1.10–6.16, p = 0.03). Conclusion In patients with optimal transplant function, iPTH levels are associated with a clinical outcome consisting of cardiovascular events, graft loss, and all-cause mortality.
Databáze:	OpenAIRE
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