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Persistent hyperparathyroidism after renal transplantation

Authors
Sri G Yarlagadda, MD
Thomas Nickolas, MD, MS
L Darryl Quarles, MD
Section Editor
Daniel C Brennan, MD, FACP
Deputy Editor
Albert Q Lam, MD

INTRODUCTION

Renal transplant recipients are vulnerable to persistent hyperparathyroidism and other disorders of mineral and bone metabolism associated with chronic kidney disease (CKD).

This topic reviews recommendations regarding monitoring and treatment of hyperparathyroidism, hypercalcemia, and hypophosphatemia among renal transplant candidates and recipients.

Other bone disorders that affect renal transplant recipients, including osteoporosis and osteonecrosis, are discussed elsewhere. (See "Bone disease after renal transplantation".)

The pathogenesis of metabolic bone disease and the treatment of hyperparathyroidism in nontransplant CKD patients are discussed elsewhere. (See "Overview of chronic kidney disease-mineral bone disease (CKD-MBD)" and "Management of secondary hyperparathyroidism and mineral metabolism abnormalities in adult predialysis patients with chronic kidney disease" and "Management of secondary hyperparathyroidism and mineral metabolism abnormalities in dialysis patients".)

PATHOPHYSIOLOGY

Most patients with chronic kidney disease (CKD) develop some degree of secondary hyperparathyroidism by the time they initiate renal replacement therapy (RRT). Secondary hyperparathyroidism occurs in response to multiple abnormalities that initially stem from decreased glomerular filtration rate (GFR) [1]. The pathophysiology of secondary hyperparathyroidism in CKD patients is discussed at length elsewhere. (See "Overview of chronic kidney disease-mineral bone disease (CKD-MBD)", section on 'Overview'.)

               

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Literature review current through: Nov 2016. | This topic last updated: Thu Mar 24 00:00:00 GMT+00:00 2016.
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