MINERAL AND BONE DISORDERS IN RENAL TRANSPLANT RECIPIENTS
Abstract
THE AIM of the study was to determine the prevalence and severity of mineral and bone metabolism in patients with chronic kidney disease (CKD) undergoing renal transplant. PATIENTS AND METHODS. The study included 77 patients (32 men, 45 women, mean age 44) with CKD who underwent transplantation of cadaveric kidneys from 2011 to 2015. Serum concentrations of electrolytes, the activity of total alkaline phosphatase (ALP), albumin, nitrogen metabolism parameters were determined by standard methods, blood concentrations of parathyroid hormone (PTH) and vitamin D (25-OH vitamin D) – by chemilumescent analysis on ARCHITECT-system. Serum calcium on serum albumin is reassessed, glomerular filtration rate (GFR) is calculated according to the formula CKD-EPI. RESULTS. Hypercalcemia, hypophosphatemia, hypomagnesemia and a high level of PTH respectively diagnosed in 15.6%, 16.9%, 16.9% and 87% patients. There was the high significant difference between blood PTH in patients with normal renal function and reduced renal graft function. The blood level of vitamin D ranged from 6 to 30 ng/ mL (median 14), only one patient was in a recommended range (≥30 ng/ml). There was the invert correlation of PTH with GFR (r=-0.543, p<0.001) and serum magnesium (r=-0.241, p=0.04), directl correlation with total ALP activity (r=0.280, p=0.015). The blood PTH is not associated with serum calcium and phosphorus. There was weak invert correlation between serum phosphorus and GFR (r=-0.232, p=0.04), between ALP activity and GFR (r =-0.267, p=0.02) and between serum magnesium and GFR (r=-0.230, p=0.05). CONCLUSION. Common manifestations of mineral and bone disorders in renal transplant recipients are pre- and post-transplantation hyperparathyroidism, which development/progression is associated with hypomagnesemia, deterioration of kidney function, as well as deficiency of vitamin D.
About the Authors
O. N. Vetchinnikova
Moscow regional research and clinical institute named after M.F. Vladimirsky
Russian Federation
Russian Federation
Olga N. Vetchinnikova MD, DMedSci.
Surgical Department of Transplantology and Dialysis, Department of Transplantology, Nephrology and Artifi cial Organs Faculty of Postgraduate Medical.
129110, Russia, Moscow, Schepkina Str. 61/2, build. 6.
E. V. Shestero
Moscow regional research and clinical institute named after M.F. Vladimirsky
Russian Federation
Russian Federation
Elena V. Shestero MD
Department of Transplantology, Nephrology and Artificial Organs Faculty of Postgraduate Medical.
129110, Russia, Moscow, Schepkina Str. 61/2, build. 6.
E. A. Еgorova
Moscow regional research and clinical institute named after M.F. Vladimirsky
Russian Federation
Russian Federation
Ekaterina A. Еgorova, MD
Laboratory Department.
129110, Russia, Moscow, Schepkina Str. 61/2, build. 6.
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For citations:
Vetchinnikova O.N., Shestero E.V., Еgorova E.A. MINERAL AND BONE DISORDERS IN RENAL TRANSPLANT RECIPIENTS. Nephrology (Saint-Petersburg). 2016;20(6):49-56. (In Russ.)
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