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KMID : 0359920070260050601
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Korean Journal of Nephrology
2007 Volume.26 No. 5 p.601 ~ p.609
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Change of Parathyroid Hormone and Markers of Bone Metabolism after Renal Transplantation
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Kim Jung-Eun
Hwang Eun-Ah
Kwak Jin-Ho
Jin Kyu-Bok
Yoon Jeong-Soo
Han Seung-Yeup
Park Sung-Bae
Kim Hyun-Chul
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Abstract
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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.
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KEYWORD
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Calcium, Secondary hyperparathyroidism, Phosphorus, Renal transplantation
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