2016 Volume 4 Issue 2 Pages 208-211
【Background】The impact of tertiary hyperparathyroidism (tHPT) on long term graft survival has been suggested. The purpose of our study was to evaluate the relationship between intact PTH (iPTH) and long term patient outcomes after kidney transplantation.【Methods】We retrospectively analyzed long-term patient outcomes for consecutive patients at Chiba East Hospital between January 2005 and December 2011. Fifty two patients had the follow-up data of iPTH. High PTH group were defined as iPTH＞188 pg/dL (median in this study) and low PTH group were defined as iPTH≦188 pg/dL. We used iPTH as a predictor and composite endpoint (death, restarting dialysis and increase of creatinine for 1.5 times) as a primary outcome. Cox proportional hazards models were used to compare the outcomes between two groups, adjusting for age and time on dialysis.【Results】Twenty three were male and twenty nine were female. The mean age was 48±10 and mean time on dialysis was 7.9±6.5 years. Baseline laboratory data were as follows；Cr 1.4±0.4 mg/dL, Ca 10.5±1.0 mg/dL, Pi 2.6±0.7 mg/dL and iPTH after kidney transplantation was 233±176 pg/mL. The mean follow-up term was 101 months. In univariate Cox proportional hazards analysis, high PTH group was significantly associated with worse long-term outcome (hazard ratio [HR] 3.7；95％ confidence interval [95％ CI], 1.1 to 12.3；p＝0.03). Multivariate analysis showed high PTH group was a marginally significant predictor of worse outcome (HR, 4.0；95％ CI, 0.97 to 16.8；p＝0.054).【Conclusion】The present study demonstrated that iPTH after kidney transplantation might be an important factor of patient outcome.
