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SHR Neuro Cancer Cardio Lipid Metab Microb

Littbarski, SA; Kaltenborn, A; Gwiasda, J; Beneke, J; Arelin, V; Schwager, Y; Stupak, JV; Marcheel, IL; Emmanouilidis, N; Jäger, MD; Scheumann, GFW; Klempnauer, J; Schrem, H.
Timing of parathyroidectomy in kidney transplant candidates with secondary hyperparathryroidism: effect of pretransplant versus early or late post-transplant parathyroidectomy.
Surgery. 2018; 163(2): 373-380. Doi: 10.1016/j.surg.2017.10.016
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Leading authors Med Uni Graz: Schrem Harald Heinrich
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Abstract:: The timing of parathyroidectomy in kidney transplant candidates suffering from secondary hyperparathyroidism before versus early or late after transplantation remains controversial. The short-term follow-up cohort comprised 66 patients with 1-year post-transplant follow-up, while the long-term follow-up cohort contained 123 patients. Risk-adjusted identification of independent risk factors for compromised renal graft function (KDIGO stage ≥ IV) was performed using multivariable regression analysis adjusted for propensity score logits for parathyroidectomy before versus after renal transplantation. Intra-individual matched-pairs analyses were used to identify significant effects of post-transplant parathyroidectomy on graft function as assessed by estimated glomerular filtration rate (eGFR) and paired t tests. Donor kidney function KDIGO stage III (P = .030; OR = 5.191, 95% CI: 1.100-24.508), donor blood group 0 (P = .005; OR = 0.176, 95% CI: 0.048-0.642), and post-transplant parathyroidectomy (P = .032; OR = 17.849, 95% CI: 1.086-293.268) were revealed as independent significant risk factors for compromised renal graft function in the short-term follow-up cohort using propensity score risk adjustment while post-transplant parathyroidectomy had no independent influence in the long-term follow-up cohort (P = .651). Parathyroidectomy after renal transplantation compromised graft function early after parathyroidectomy and at last follow-up in all post-transplant parathyroidectomy cases (P ≤ .004). Parathyroidectomy within the first post-transplant year was associated with compromised renal graft function until last follow-up (P = .004), while parathyroidectomy late post-transplant was not. Parathyroidectomy should be conducted before transplantation or, if this is not possible, preferably after the first post-transplant year. Copyright © 2017. Published by Elsevier Inc.
Find related publications in this database (using NLM MeSH Indexing): Female -; Humans -; Kidney Transplantation -; Male -; Middle Aged -; Parathyroidectomy - adverse effects; Propensity Score -; Retrospective Studies -; Risk Factors -; Time Factors -