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Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function
Author(s) -
Bleskestad Inger H.,
Bergrem Harald,
Leivestad Torbjørn,
Hartmann Anders,
Gøransson Lasse G.
Publication year - 2014
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12341
Subject(s) - medicine , interquartile range , transplantation , renal function , quartile , kidney transplantation , dialysis , hazard ratio , urology , proportional hazards model , kidney disease , diabetes mellitus , surgery , endocrinology , confidence interval
Background The aim of the study was to investigate whether serum levels of intact parathyroid hormone ( iPTH ) are associated with an increased risk of cardiovascular events, graft loss, or mortality in kidney transplant patients with optimal transplant function. Methods From the Norwegian Renal Registry, we identified 522 patients who received a first kidney transplant from 2001 to 2008 with optimal transplant function defined as an estimated glomerular filtration rate ( eGFR ) ≥ 60 mL/min/1.73 m 2 , more than one yr after transplantation. Cox's proportional hazard models were used to assess the association between iPTH measured 10 wk after transplantation and the composite endpoint. The estimates were adjusted for age, gender, serum calcium, serum phosphate, diabetes mellitus, cardiovascular disease, and time on dialysis prior to transplantation. Results Median follow‐up time was 3.9 yr (interquartile range, IQR: 2.0–6.0 yr). Patients in the third iPTH quartile (9.3–14.4 pM) had the lowest risk for reaching the composite endpoint. Patients in the fourth iPTH quartile (>14.4 pM) had an increased risk compared to those in the third quartile (HR: 2.60, 95% CI: 1.10–6.16, p = 0.03). Conclusion In patients with optimal transplant function, iPTH levels are associated with a clinical outcome consisting of cardiovascular events, graft loss, and all‐cause mortality.