Abstract
Background
Recently, preemptive kidney transplantation (PKT) has increased in Japan; however, the effects of PKT on calcium (Ca) and phosphorus (Pi) metabolism are poorly understood.
Methods
Thirty-two consecutive patients were enrolled in this study at Nagoya Daini Red Cross Hospital. Fifteen patients were in the PKT group and 17 patients were in the non-PKT group. Parameters of Ca and Pi metabolism, including fibroblast growth factor (FGF) 23 and intact parathyroid hormone, were measured before transplantation and 1, 3, and 24 weeks after transplantation.
Results
FGF 23 decreased dramatically in both groups after transplantation; however, FGF 23 before transplantation and at 1 and 3 weeks after transplantation was significantly lower in the PKT group than in the non-PKT group (p < 0.05). Although iPTH levels were higher in the PKT group than in the non-PKT group before transplantation, these levels were lower in the PKT group at 24 weeks after transplantation (p < 0.05). Corrected Ca was lower at 24 weeks in the PKT group (p < 0.05), whereas Pi was lower in the non-PKT group at 1 and 3 weeks (p < 0.05), but not significantly different at 24 weeks. Multivariate linear regression analysis revealed that FGF 23 before transplantation was the strongest predictor of Ca and Pi disorders in early post-transplant recipients.
Conclusions
This study suggests that PKT has beneficial effects on Ca and Pi metabolism and pre-transplant FGF 23 levels are a good marker of post-transplant Ca and Pi metabolism disorders.
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Abbreviations
- PKT:
-
Preemptive kidney transplantation
- Ca:
-
Calcium
- Pi:
-
Phosphorus
- FGF:
-
Fibroblast growth factor
- iPTH:
-
Intact parathyroid hormone
- MBDS:
-
Mineral and bone disorders
- VDRAs:
-
Vitamin D receptor activators
- HD:
-
Hemodialysis
- GFR:
-
Estimated glomerular filtration rate
- Corrected Ca:
-
cCa
- Cre:
-
Creatinine
- TmP/GFR:
-
Tubular maximum reabsorption of Pi corrected for GFR
- AUC 0–4 h:
-
Area under the blood concentration time curve 0–4 h
- DFPP:
-
Double filtration plasmapheresis
- PE:
-
Plasma exchange
- eGFR:
-
Estimated GFR
- HPT:
-
Persistent hyperparathyroidism
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Acknowledgments
We sincerely thank all the staff of the Kidney Disease Center at Nagoya Daini Red Cross Hospital for their cooperation with this study. This work was partly supported by grants from The Kidney Foundation, Japan. (JKFB 12-62).
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We declare no financial conflicts.
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Tsujita, M., Inaguma, D., Goto, N. et al. Beneficial effects of preemptive kidney transplantation on calcium and phosphorus disorders in early post-transplant recipients. Clin Exp Nephrol 19, 319–324 (2015). https://doi.org/10.1007/s10157-014-0967-0
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DOI: https://doi.org/10.1007/s10157-014-0967-0