Korean Journal of Nephrology 2007;26(5):601-609.
Change of Parathyroid Hormone and Markers of Bone Metabolism after Renal Transplantation
Jung Eun Kim, M.D., Eun Ah Hwang, M.D., Jin Ho Kwak, M.D., Kyu Bok Jin, M.D. Jeong Soo Yoon, M.D., Seung Yeup Han, M.D., Sung Bae Park, M.D. and Hyun Chul Kim, M.D.
Department of Internal Medicine, Keimyung University School of Medicine, Kidney Institute
신이식 후 부갑상선 호르몬 및 골대사 지표의 자연경과
김정은 황은아 곽진호 진규복 윤정수 한승엽 박성배 김현철
계명대학교 의과대학 내과학교실, 신장연구소
Abstract
Purpose : The aims of this retrospective study were to evaluate the sequential changes of parathyroid hormone (iPTH) and calcium metabolism after renal transplantation (RTP) and to identify risk factors for hypertension (HPT). Methods : Biochemical bone parameters were reviewed in 264 patients at pre-transplant, 6, 12, 36 and 60 months after RTP. Results : iPTH levels fell significantly during the first six months after RTP and remained substantially stable thereafter. The mean total serum calcium level showed significant increase during the first six months and progressive and significant decline after the first year. The mean serum phosphorus level returned to the normal range during the first six months and remained normal thereafter. The serum alkaline phosphatase (ALP) level increased during the first year and gradually decreased after then. The prevalence of persistent HPT was 17.8%. Patients with persistent HPT had significantly elevated serum levels of iPTH at the time of RTP and had spent a longer time on dialysis. Significant positive correlations were observed between the serum iPTH levels on the one hand and the pre-transplant iPTH, serum ALP, and creatinine levels on the other hand. Conclusion : The prevalence of persistent HPT after RTP is not uncommon. The patients with long duration of dialysis showing high serum level of iPTH at the time of transplantation are at risk for persistent HPT.
Key Words: Calcium, Secondary hyperparathyroidism, Phosphorus, Renal transplantation


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