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Erschienen in: Langenbeck's Archives of Surgery 6/2022

21.05.2022 | Original Article

Impact of parathyroidectomy on kidney graft function in post-transplant tertiary hyperparathyroidism: a comparative study

verfasst von: Samuel Frey, Thomas Goronflot, Claire Blanchard, Clarisse Kerleau, Pierre-Antoine Gourraud, Matthieu Wargny, Cécile Caillard, Maryvonne Hourmant, Lucile Figueres, Éric Mirallié, DIVAT Consortium

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2022

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Abstract

Purpose

Parathyroidectomy to treat tertiary hyperparathyroidism (THPT) is now on a par with calcimimetic treatment. The effects of cinacalcet and parathyroidectomy on kidney transplant function remain controversial. The aim of this study was to evaluate kidney transplant function in THPT patients treated either by parathyroidectomy, cinacalcet, or not treated.

Methods

Between 2009 and 2019, 231 patients with functional grafts presenting THPT, defined either by calcaemia superior to 2.5 mmol/L with elevated PTH level or hypercalcaemia with non-adapted PTH level 1 year after kidney transplantation, were included. Hyperparathyroid patients treated by cinacalcet and parathyroidectomy were matched for age, sex, graft rank, and baseline eGFR with cinacalcet-only and untreated patients. Conditional logistic regression models were used to compare eGFR variations 1 year after parathyroidectomy between operated patients and matched controls. Five-year survivals were compared with the Mantel-Cox test.

Results

Eleven patients treated with parathyroidectomy and cinacalcet were matched with 16 patients treated by cinacalcet-only and 29 untreated patients. Demographic characteristics were comparable between groups. Estimated odds ratios for eGFR evolution in operated patients compared with cinacalcet-only and untreated patients were 0.92 [95%CI 0.83–1.02] and 0.99 [0.89–1.10] respectively, indicating no significant impairment of eGFR 1 year after surgery. Five-year allograft survival was not significantly impaired in operated patients.

Conclusions

Parathyroidectomy did not appear to substantially alter or improve graft function 1 year after surgery or 5-year allograft survival. It could be hypothesized that in addition to its known benefits, parathyroidectomy can be safely performed vis-à-vis graft function in tertiary hyperparathyroidism.
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Metadaten
Titel
Impact of parathyroidectomy on kidney graft function in post-transplant tertiary hyperparathyroidism: a comparative study
verfasst von
Samuel Frey
Thomas Goronflot
Claire Blanchard
Clarisse Kerleau
Pierre-Antoine Gourraud
Matthieu Wargny
Cécile Caillard
Maryvonne Hourmant
Lucile Figueres
Éric Mirallié
DIVAT Consortium
Publikationsdatum
21.05.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2022
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-022-02555-z

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