Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study
PurposeWe studied the association between parathormone (PTH) levels and long-term graft loss in RTx patients (RTx-p).MethodsWe retrospectively evaluated 871 RTx-p, transplanted in our unit from Jan-2004 to Dec-2020 assessing renal function and mineral metabolism parameters at 1, 6, and 12 months aft...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1221086/full |
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| author | Paolo Molinari Paolo Molinari Anna Regalia Alessandro Leoni Mariarosaria Campise Donata Cresseri Elisa Cicero Elisa Cicero Simone Vettoretti Luca Nardelli Emilietta Brigati Evaldo Favi Evaldo Favi Piergiorgio Messa Giuseppe Castellano Giuseppe Castellano Carlo M. Alfieri Carlo M. Alfieri |
| author_facet | Paolo Molinari Paolo Molinari Anna Regalia Alessandro Leoni Mariarosaria Campise Donata Cresseri Elisa Cicero Elisa Cicero Simone Vettoretti Luca Nardelli Emilietta Brigati Evaldo Favi Evaldo Favi Piergiorgio Messa Giuseppe Castellano Giuseppe Castellano Carlo M. Alfieri Carlo M. Alfieri |
| author_sort | Paolo Molinari |
| collection | DOAJ |
| description | PurposeWe studied the association between parathormone (PTH) levels and long-term graft loss in RTx patients (RTx-p).MethodsWe retrospectively evaluated 871 RTx-p, transplanted in our unit from Jan-2004 to Dec-2020 assessing renal function and mineral metabolism parameters at 1, 6, and 12 months after RTx. Graft loss and death with functioning graft during follow-up (FU, 8.3[5.4–11.4] years) were checked.ResultsAt month-1, 79% had HPT, of which 63% with secondary HPT (SHPT) and 16% tertiary HPT (THPT); at month-6, HPT prevalence was 80% of which SHPT 64% and THPT 16%; at month-12 HPT prevalence was 77% of which SHPT 62% and THPT 15%. A strong significant correlation was found between HPT type, PTH levels and graft loss at every time point. Mean PTH exposure remained strongly and independently associated to long term graft loss (OR 3.1 [1.4–7.1], p = 0.008). THPT was independently associated with graft loss at month-1 when compared to HPT absence and at every time point when compared to SHPT. No correlation was found with RTx-p death. Discriminatory analyses identified the best mean PTH cut-off to predict long-term graft loss to be between 88.6 and 89.9 pg/mL (AUC = 0.658). Cox regression analyses highlighted that THPT was strongly associated with shorter long-term graft survival at every time-point considered.ConclusionHigh PTH levels during 1st year of RTx seem to be associated with long term graft loss. |
| first_indexed | 2024-03-08T09:36:52Z |
| format | Article |
| id | doaj.art-7052041e0e4f4f878639b79224dd4742 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-08T09:36:52Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-7052041e0e4f4f878639b79224dd47422024-01-30T08:05:35ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-08-011010.3389/fmed.2023.12210861221086Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort studyPaolo Molinari0Paolo Molinari1Anna Regalia2Alessandro Leoni3Mariarosaria Campise4Donata Cresseri5Elisa Cicero6Elisa Cicero7Simone Vettoretti8Luca Nardelli9Emilietta Brigati10Evaldo Favi11Evaldo Favi12Piergiorgio Messa13Giuseppe Castellano14Giuseppe Castellano15Carlo M. Alfieri16Carlo M. Alfieri17Unit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyPost-Graduate School of Specialization in Nephrology, University of Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyPost-Graduate School of Specialization in Nephrology, University of Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, ItalyGeneral Surgery and Kidney Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, ItalyDepartment of Nephrology, Dialysis and Kidney Transplants, IRCCS Ca’ Granda Foundation Maggiore Policlinico Hospital, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, ItalyUnit of Nephrology, Dialysis and Kidney Transplantation, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, ItalyDepartment of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, ItalyPurposeWe studied the association between parathormone (PTH) levels and long-term graft loss in RTx patients (RTx-p).MethodsWe retrospectively evaluated 871 RTx-p, transplanted in our unit from Jan-2004 to Dec-2020 assessing renal function and mineral metabolism parameters at 1, 6, and 12 months after RTx. Graft loss and death with functioning graft during follow-up (FU, 8.3[5.4–11.4] years) were checked.ResultsAt month-1, 79% had HPT, of which 63% with secondary HPT (SHPT) and 16% tertiary HPT (THPT); at month-6, HPT prevalence was 80% of which SHPT 64% and THPT 16%; at month-12 HPT prevalence was 77% of which SHPT 62% and THPT 15%. A strong significant correlation was found between HPT type, PTH levels and graft loss at every time point. Mean PTH exposure remained strongly and independently associated to long term graft loss (OR 3.1 [1.4–7.1], p = 0.008). THPT was independently associated with graft loss at month-1 when compared to HPT absence and at every time point when compared to SHPT. No correlation was found with RTx-p death. Discriminatory analyses identified the best mean PTH cut-off to predict long-term graft loss to be between 88.6 and 89.9 pg/mL (AUC = 0.658). Cox regression analyses highlighted that THPT was strongly associated with shorter long-term graft survival at every time-point considered.ConclusionHigh PTH levels during 1st year of RTx seem to be associated with long term graft loss.https://www.frontiersin.org/articles/10.3389/fmed.2023.1221086/fullkidney transplantationparathormonehyperparathyroidismtertiary hyperparathyroidismgraft outcome |
| spellingShingle | Paolo Molinari Paolo Molinari Anna Regalia Alessandro Leoni Mariarosaria Campise Donata Cresseri Elisa Cicero Elisa Cicero Simone Vettoretti Luca Nardelli Emilietta Brigati Evaldo Favi Evaldo Favi Piergiorgio Messa Giuseppe Castellano Giuseppe Castellano Carlo M. Alfieri Carlo M. Alfieri Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study Frontiers in Medicine kidney transplantation parathormone hyperparathyroidism tertiary hyperparathyroidism graft outcome |
| title | Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study |
| title_full | Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study |
| title_fullStr | Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study |
| title_full_unstemmed | Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study |
| title_short | Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study |
| title_sort | impact of hyperparathyroidism and its different subtypes on long term graft outcome a single transplant center cohort study |
| topic | kidney transplantation parathormone hyperparathyroidism tertiary hyperparathyroidism graft outcome |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1221086/full |
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