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Prevalence and predictors of early hypercalcemia after kidney transplantation: a nested case–control study within a cohort of 100 patients

Clinical and Experimental Nephrology volume 23, pages 268–274 (2019)Cite this article

Abstract

Background

Hypercalcemia (HC) after kidney transplantation (KTx) can deteriorate both graft and patient survival. However, HC as a clinical condition and its clinical significance after KTx remain unknown. We evaluated the prevalence and risk factors of early HC after KTx.

Methods

We performed a nested case–control study using a cohort of 100 KTx patients. KTx patients were divided into the HC and normocalcemia (NC) groups based on the baseline serum-corrected calcium (cCa) levels (≥ 10.5 and < 10.5 mg/dL) within 1 year after KTx.

Results

Overall, the median value of maximum serum cCa level within 1 year after KTx was 10.1 (9.1–13.8) mg/dL. Of the 100 KTx patients within the cohort, 31 patients (31.0%) were classified as the HC group. The maximum serum cCa level was reached significantly earlier in the HC group compared with the NC group (2 vs. 4 months, p = 0.024). In univariate analysis, the risk factors of early HC after KTx were dialysis duration ≥ 10 years, serum cCa level the day before KTx, and cinacalcet administration before KTx. Among these risk factors, serum cCa level the day before KTx and cinacalcet administration before KTx were identified as significant independent risk factors of early HC after KTx in multivariate analysis.

Conclusions

One-third of the KTx patients presented early HC within 1 year after KTx. Early HC after KTx resulted from persistent hyperparathyroidism. Therapeutic strategies to manage HC after KTx must be established.

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Affiliations

  1. Surgical Branch, Institute of Kidney Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan

    Koji Nanmoku, Takahiro Shinzato, Taro Kubo, Toshihiro Shimizu & Takashi Yagisawa

Authors
  1. Koji Nanmoku
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  2. Takahiro Shinzato
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  3. Taro Kubo
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  4. Toshihiro Shimizu
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  5. Takashi Yagisawa
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Corresponding author

Correspondence to Koji Nanmoku.

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Conflict of interest

The authors have declared that no conflict of interest exists.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee at which the studies were conducted (IRB Approval No. A16-111) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Because this was an observational but not prospective intervention study, the Ethics Committee provided a waiver of informed consent.

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Nanmoku, K., Shinzato, T., Kubo, T. et al. Prevalence and predictors of early hypercalcemia after kidney transplantation: a nested case–control study within a cohort of 100 patients. Clin Exp Nephrol 23, 268–274 (2019). https://doi.org/10.1007/s10157-018-1627-6

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  • DOI: https://doi.org/10.1007/s10157-018-1627-6

Keywords

  • Kidney transplantation
  • Hypercalcemia
  • Chronic kidney disease–mineral and bone disorder
  • End-stage kidney disease
  • Hyperparathyroidism
  • Cinacalcet