| Theme |
Parathyroid diseases and their pathogenesis |
| Title |
Tertiary hyperparathyroidism post renal transplantation |
| Author |
Toshihide Naganuma |
Department of Urology, Osaka City University Medical School |
| Author |
Yoshiaki Takemoto |
Department of Urology, Osaka City University Medical School |
| Author |
Junji Uchida |
Department of Urology, Osaka City University Medical School |
| Author |
Tatsuya Nakatani |
Department of Urology, Osaka City University Medical School |
| [ Summary ] |
The clinical Practice Guideline for CKD-MBD (chronic kidney disease-mineral and bone disorders) was released by the Japanese Society for Dialysis Therapy in 2012. The issue of CKD-MBD after renal transplantation, was covered in several statements on the treatment of tertiary hyperparathyroidism addressed in that guideline. The chronic phase after transplantation, was commented on with the following quote : "parathyroid intervention should be considered when hypercalcemia (especially at corrected levels of Ca ≥10.5 mg/dl) and high serum PTH (higher than baseline levels) may continue up to one year post-transplant." However, there is not enough evidence to support this statement, and it is not clear whether cinacalcet treatment is sufficient or parathyroidectomy should be immediately performed. More evidence should be collected not only on the prognosis for kidney transplant patients but also on the expected life span of transplant recipients in regard to cardiovascular diseases such as vascular calcification before making conclusions on this subject. |