Prospective Study of Post Renal Transplant Mineral Bone Disorder: A Single Center Experience

To evaluate sequential changes in biochemical bone parameters, parathyroid hormone (iPTH), and vitamin D levels over a period of 24 weeks after renal transplantation, we studied 52 patients (41 males, with a mean age of 31.98) who underwent their first renal transplantation without a past history of parathyroid surgery or fractures. Serum calcium, phosphorus, albumin, Serum iPTH and vitamin D levels were measured before transplant, then at 2, 4, 12 and 24 weeks post transplantation. Serum calcium showed a significant increase from 2 to 12 weeks after transplantation, followed by a slight decline until 24 weeks. At the end of 12 and 24 weeks, 6 (11.53%) and 2 (3.8%) patients had hypercalcemia respectively. At the end of 12 weeks only 15.38% (8) patients had hypocalcemia and no patient had hypocalcemia at the end of 24 weeks. Serum phosphorus showed significant decline in the first 4 weeks post transplantation. At the end of 24 weeks 21.2% still had hypophosphatemia. iPTH levels declined rapidly in the first 4 weeks of post-transplant period and there after decline slowly till the end of 24 weeks. Baseline iPTH and vitamin D3 levels did not correlate with persistent HPT. Hypovitaminosis D was seen in 16 (30.7%), 8 (15.3%) and 11 (21.1%) patients at pre-transplant, 12, and 24 weeks posttransplant respectively. Unlike most studies in literature our patient population experienced lower prevalence of post-transplant hypercalcemia, Hypovitaminosis D, and hyperparathyroidism which may have resulted from younger study population and shorter dialysis vintage.

Author(s): Senthil Kumar Kasi

Abstract | Full-Text | PDF

Share This Article