Title: Calcium Metabolism in the Early Posttransplantation Period
Authors: Evenepoel, Pieter ×
Van Den Bergh, Barbara
Naesens, Maarten
de Jonge, Hylke
Bammens, Bert
Claes, Kathleen
Kuypers, Dirk
Vanrenterghem, Yves #
Issue Date: Mar-2009
Publisher: American Society of Nephrology
Series Title: Clinical Journal of the American Society of Nephrology vol:4 issue:3 pages:665-672
Abstract: BACKGROUND AND OBJECTIVES: Information on the time course of serum calcium levels after renal transplantation is scanty, especially in the early posttransplantation period. Both the abrupt cessation of calcium-containing phosphorus binders and vitamin D (analogs) at the time of surgery and the recovery of renal function may be hypothesized to affect serum calcium levels in this period. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this prospective observational study, biointact parathyroid hormone, calcidiol, calcitriol, calcium, and phosphorus levels were monitored in 201 renal transplant recipients at the time of transplantation and 3 mo thereafter. In addition, the serum calcium nadir and peak in each individual patient within this time frame were identified and the urinary fractional calcium excretion was determined at month 3. RESULTS: Serum calcium levels followed a biphasic pattern with a significant decline during the first postoperative week, followed by a significant increase. High pretransplantation parathyroid hormone levels protect against hypocalcemia within the first postoperative week but put patients at risk for hypercalcemia later. These complications, occurring in 41 and 14% of the patients, respectively, most probably reflect inappropriate calcium release from the skeleton, rather than inappropriate renal calcium handling. CONCLUSIONS: Our data indicate that both hypo- and hypercalcemia are prevalent in the early posttransplantation period. Pretransplantation parathyroid function is an important predictor of posttransplantation calcium levels.
ISSN: 1555-9041
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Nephrology
Department of Microbiology & Immunology - miscellaneous
× corresponding author
# (joint) last author

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