Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
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DOI：
10.1155/2016/7126290
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发表时间：
2016-01-01
影响因子：
2.1
通讯作者：
Karim, Nazmul
中科院分区：
文献类型：
--
作者：
Amin, Tony;Coates, P. Toby;Karim, Nazmul
导论.肾移植后骨病是一个重要的问题。影响肾移植后骨状态的因素包括高剂量急性和低剂量长期类固醇使用，持续高钙血症和移植物衰竭。在这项研究中，我们的目的是确定高钙血症的患病率，并评估在我们的中心长期肾移植患者肾移植后高钙血症的危险因素。方法.这是一项生化稽查，我们研究了来自南澳中北方阿德莱德肾移植服务中心的肾移植受者。入选标准包括自1971年以来移植物功能正常且在分析时移植后至少3个月的肾移植患者。高钙血症定义为连续3个月血清校正钙持续升高大于或等于2.56 mmol/L。结果研究了679例移植物功能正常的肾移植受者，其中101例在2011年3月至2011年6月期间发生高钙血症（15%）。60%的高钙血症患者为男性，40%为女性，慢性肾小球肾炎（39%）是其终末期肾病（ESKD）的最常见原因。在移植前接受血液透析和腹膜透析的患者中，患病率相似。肾移植人群中的高钙血症不是继发于移植物功能欠佳，而是继发于移植前甲状旁腺功能亢进，移植后甲状旁腺激素（PTH）水平持续升高。结论肾移植受者中高钙血症的患病率很高（15%）。高钙血症的主要原因是移植前甲状旁腺功能亢进。移植前甲状旁腺功能亢进的程度是长期甲状旁腺功能的主要决定因素，而不是移植物功能或移植前透析时间或透析方式。
Introduction. Postrenal transplant bone disease is a significant problem. Factors influencing postrenal transplant bone status include high dose acute and low dose long-term steroid use, persistent hypercalcaemia, and graft failure. In this study, we aimed to determine the prevalence of hypercalcaemia and to evaluate the risk factors for postrenal transplant hypercalcaemia in long-term renal transplant patients at our centre. Methods. This is a biochemical audit in which we studied renal transplant recipients from the Central Northern Adelaide Renal Transplant Services, South Australia. Inclusion criteria include kidney transplant patients with functioning graft since 1971 and at least 3 months after transplantation at the time of analysis. Hypercalcaemia was defined as persistently elevated serum corrected calcium greater than or equal to 2.56 mmol/L for three consecutive months. Results. 679 renal transplant recipients with a functioning graft were studied and 101 were hypercalcaemic between March 2011 and June 2011 (15%). 60% of the hypercalcaemic patients were male and 40% were female, with chronic glomerulonephritis (39%) being the commonest cause of their end stage kidney disease (ESKD). Prevalence was similar in those that had haemodialysis and peritoneal dialysis pretransplantation. Hypercalcaemia in the renal transplant population was not secondary to suboptimal allograft function but secondary to pretransplantation hyperparathyroidism with persistent high parathyroid hormone (PTH) levels after transplantation. Conclusion. There is a high prevalence of hypercalcaemia (15%) in renal transplant recipients. The predominant cause for hypercalcaemia is pretransplantation hyperparathyroidism. The magnitude of pretransplantation hyperparathyroidism is the major determinant for long-term parathyroid function rather than graft function or pretransplantation duration on dialysis or mode of dialysis.