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Pihlstrøm, H; Dahle, DO; Mjøen, G; Pilz, S; März, W; Abedini, S; Holme, I; Fellström, B; Jardine, AG; Holdaas, H.
Increased risk of all-cause mortality and renal graft loss in stable renal transplant recipients with hyperparathyroidism.
Transplantation. 2015; 99(2):351-359
Doi: 10.1097/TP.0000000000000583
[OPEN ACCESS]
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
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März Winfried
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Pilz Stefan
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- Abstract:
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Hyperparathyroidism is reported in 10% to 66% of renal transplant recipients (RTR). The influence of persisting hyperparathyroidism on long-term clinical outcomes in RTR has not been examined in a large prospective study.
We investigated the association between baseline parathyroid hormone (PTH) levels and major cardiovascular events, renal graft loss, and all-cause mortality by Cox Proportional Hazard survival analyses in 1840 stable RTR derived from the Assessment of LEscol in Renal Transplantation trial. Patients were recruited in a mean of 5.1 years after transplantation, and follow-up time was 6 to 7 years.
Significant associations between PTH and all 3 outcomes were found in univariate analyses. When adjusting for a range of plausible confounders, including measures of renal function and serum mineral levels, PTH remained significantly associated with all-cause mortality (4% increased risk per 10 units; P=0.004), and with graft loss (6% increased risk per 10 units; P<0.001), but not with major cardiovascular events. Parathyroid hormone above the upper limit of normal (65 pg/mL) indicated a 46% (P=0.006) higher risk of death and an 85% higher risk of graft loss (P<0.001) compared with low/normal values.
Hyperparathyroidism is an independent, potentially remediable, risk factor for renal graft loss and all-cause mortality in RTR.
- Find related publications in this database (using NLM MeSH Indexing)
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Adult -
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Biomarkers - blood
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Cardiovascular Diseases - etiology
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Cardiovascular Diseases - mortality
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Cause of Death -
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Chi-Square Distribution -
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Female -
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Graft Survival -
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Humans -
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Hyperparathyroidism - blood
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Hyperparathyroidism - diagnosis
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Hyperparathyroidism - etiology
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Hyperparathyroidism - mortality
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Kidney Failure, Chronic - complications
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Kidney Failure, Chronic - diagnosis
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Kidney Failure, Chronic - mortality
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Kidney Failure, Chronic - surgery
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Kidney Transplantation - adverse effects
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Kidney Transplantation - mortality
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Linear Models -
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Male -
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Middle Aged -
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Multivariate Analysis -
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Parathyroid Hormone - blood
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Proportional Hazards Models -
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Randomized Controlled Trials as Topic -
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Retrospective Studies -
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Risk Factors -
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Time Factors -
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Treatment Outcome -
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Up-Regulation -