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Persistent secondary hyperparathyroidism after renal transplantation in children

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Abstract

Secondary hyperparathyroidism (HPTH) is a frequent complication of chronic kidney disease (CKD). Renal transplantation corrects the biochemical abnormalities that cause HPTH; however, HPTH persists in some patients. The factors that contribute to the persistence of HPTH after transplantation in children are poorly understood. We examined 57 children who underwent renal transplantation and determined whether baseline clinical and biochemical parameters could predict the persistence of HPTH at 1 year post-transplantation, using multivariate logistic regression. At the time of transplantation, serum parathyroid hormone (PTH) levels were >300 pg/ml in 60%, 150–300 pg/ml in 17%, and <150 pg/ml in 23% of recipients. HPTH (PTH >73 pg/ml) persisted in 78% of patients at 6 months and in 56% at 1 year after transplant. Older age at transplantation was the strongest predictor of HPTH at 1 year (OR=1.17, P<0.05). After adjustment for age, other baseline clinical or laboratory parameters were not predictive of HPTH at 1 year. The relationship between older age and persistent HPTH may be explained by longer duration of CKD. Given the potential morbidities associated with persistent HPTH, the role of interventions that would prevent or reverse persistent HPTH post-transplantation requires further investigation.

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Acknowledgments

This research was supported in part by the Glaser Pediatric Research Network.

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Authors and Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, California, USA

    Mina Matsuda-Abedini, Anthony A. Portale, Amol Shah, Marilyn McEnhill & Robert S. Mathias

  2. Department of Biostatistics, University of California, San Francisco, California, USA

    John Neuhaus

  3. The University of California at San Francisco Children’s Hospital, 533 Parnassus Avenue, Room U 585, San Francisco, CA 94143-0748, USA

    Robert S. Mathias

Authors
  1. Mina Matsuda-Abedini
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  2. Anthony A. Portale
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  3. Amol Shah
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  4. John Neuhaus
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  5. Marilyn McEnhill
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  6. Robert S. Mathias
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Correspondence to Robert S. Mathias.

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Matsuda-Abedini, M., Portale, A.A., Shah, A. et al. Persistent secondary hyperparathyroidism after renal transplantation in children. Pediatr Nephrol 21, 413–418 (2006). https://doi.org/10.1007/s00467-005-2113-4

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  • DOI: https://doi.org/10.1007/s00467-005-2113-4

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