Abstract
Hypophosphatemia is common after renal transplantation and has been variously ascribed to persistent hyperparathyroidism, to tubular damage from rejection, or to the effect of corticosteroid or immunosuppressive therapy (1–3). To learn more about the mechanisms, we measured TmP/GFR, nephrogenous cyclic AMP (NcAMP) and immunoreactive PTH in 25 renal transplant patients with stable renal function (Ccr≥70 ml/min/1.73 m2,≥6 months post-transplant), 21 healthy control subjects and 5 uninephrectomized renal transplant donors. On the basis of the parathyroid function tests, we divided the patients into three groups. In Group 1 (5 patients) serum calcium, NcAMP and PTH were all normal; these patients had resolved hyperparathyroidism. In Group 2 (6 patients) serum calcium, NcAMP and PTH. were all raised; these patients had persistent hypercalcemic hyperparathyroidism. In Group 3 (14 patients) serum calcium was normal but either NcAMP or iPTH or both were raised; these patients had persistent normocalcemic hyperparathyroidism. These three groups did not differ significantly in duration of graft survival, creatinine clearance, type or dose of immunosuppressive therapy, or serum levels of vitamin D metabolites.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
H.N. Ward, R.C. Pabico, B.A. McKenna and R.B. Freeman, The The renal handling of phosphate by renal transplant patients: correlation with serum parathyroid hormone, cyclic 3′,5′ — adenosine monophosphate urinary excretion, and allograft function, Adv. Exp. Med. Biol. 81:173 (1977).
N.D. Vaziri, R.E. Nellans, R.M. Brueggemann, C.H. Barton and D.C. Martin. Renal tubular dysfunction in transplanted kidneys. Southern Med. J. 72:530 (1979).
M. Garabedian, C. Silve, D. Levy, A. Bourdeau, A. Ulmann, M. Broyer and S. Balsan, Chronic hypophosphatemia in kidney transplanted children and young adults, Adv. Med. Biol 128:249, (1980).
R.C. Pabico, B.A. McKenna and R.B. Freeman, Renal function before and after unilateral nephrectomy in renal donors, Kidney Int. 8:166 (1975).
S.G. Massry, J.W. Coburn, D.B.N. Lee, J. Jowsey, C.R. Kleeman, Skeletal resistance to parathyroid hormone in renal failure. Ann. Intern. Med. 78:357 (1973).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1982 Plenum Press, New York
About this chapter
Cite this chapter
Kleerekoper, M., Bernstein, R.S., Cruz, C., Levin, N.W., Parfitt, A.M. (1982). Parathyroid Hormone Resistance in Renal Allograft Recipients. In: Massry, S.G., Letteri, J.M., Ritz, E. (eds) Regulation of Phosphate and Mineral Metabolism. Advances in Experimental Medicine and Biology, vol 151. Springer, Boston, MA. https://doi.org/10.1007/978-1-4684-4259-5_24
Download citation
DOI: https://doi.org/10.1007/978-1-4684-4259-5_24
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4684-4261-8
Online ISBN: 978-1-4684-4259-5
eBook Packages: Springer Book Archive