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NDT Advance Access originally published online on June 8, 2006
Nephrology Dialysis Transplantation 2006 21(7):1766-1769; doi:10.1093/ndt/gfl283
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Editorial Comment

Parathyroidectomy vs calcimimetics for treatment of persistent hyperparathyroidism after kidney transplantation

Ewa Lewin1 and Klaus Olgaard2

1 Nephrological Department B, Herlev Hospital and 2 Nephrological Department P, Rigshospitalet, University of Copenhagen, Denmark

Correspondence and offprint requests to: Klaus Olgaard, MD, Professor, Department of Nephrology P2132, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. Email: olgaard@rh.dk

Keywords: calcimimetics; kidney transplantation; parathyroidectomy; persistent hyperparathyroidism

The first 150 words of the full text of this article appear below.



   Persistent hyperparathyroidism after kidney transplantation
 
Ideally, a successful kidney transplantation corrects the abnormalities in mineral metabolism that, during uraemia, lead to secondary hyperparathyroidism (HPT) and renal osteodystrophy. This includes reversal of uraemia, abolition of hypocalcaemia, hyperphosphataemia and acidosis, and restoration of calcitriol production and reversal of skeletal resistance to parathyroid hormone (PTH) and vitamin D [1].

Elevated PTH levels persist in a significant number of renal transplant patients. In addition to its potential negative consequences on bone mineralization, persistent HPT might worsen hypercalcaemia, induce hypophosphataemia, and may be a risk factor for acute tubular necrosis in the renal allograft [2].

The incidence of hypercalcaemia after kidney transplantation is significant and varies between 8.5 and 65%. The natural evolution of hypercalcaemia after successful kidney transplantation is, however, in most cases a spontaneous resolution [3,4] and the pathogenesis of post-transplant hypercalcaemia is not necessarily due to persistent HPT. Several . . . [Full Text of this Article]



   Parathyroidectomy after kidney transplantation
 


   Treatment with calcimimetics after kidney transplantation
 


   Effects on the skeleton
 


   Conclusions
 

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