Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study

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 hypercalcaem...

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Main Authors: Tony Amin, P. Toby Coates, Jeffrey Barbara, Paul Hakendorf, Nazmul Karim
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.1155/2016/7126290
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author Tony Amin
P. Toby Coates
Jeffrey Barbara
Paul Hakendorf
Nazmul Karim
author_facet Tony Amin
P. Toby Coates
Jeffrey Barbara
Paul Hakendorf
Nazmul Karim
author_sort Tony Amin
collection DOAJ
description 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.
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spelling doaj-art-80b9c7a242eb4165b590d11ae396a69d2025-02-03T05:52:07ZengWileyInternational Journal of Nephrology2090-214X2090-21582016-01-01201610.1155/2016/71262907126290Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre StudyTony Amin0P. Toby Coates1Jeffrey Barbara2Paul Hakendorf3Nazmul Karim4Central Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaCentral Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaCentral Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaCentral Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaCentral Northern Adelaide Renal and Transplantation Services, Royal Adelaide Hospital, Adelaide, SA 5000, AustraliaIntroduction. 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.http://dx.doi.org/10.1155/2016/7126290
spellingShingle Tony Amin
P. Toby Coates
Jeffrey Barbara
Paul Hakendorf
Nazmul Karim
Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
International Journal of Nephrology
title Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
title_full Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
title_fullStr Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
title_full_unstemmed Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
title_short Prevalence of Hypercalcaemia in a Renal Transplant Population: A Single Centre Study
title_sort prevalence of hypercalcaemia in a renal transplant population a single centre study
url http://dx.doi.org/10.1155/2016/7126290
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