Soluble Klotho and intact fibroblast growth factor 23 in long-term kidney transplant patients

Abstract

Background: Controversies exist whether disturbances in mineral and bone disorder (MBD) normalise or persist after kidney transplantation. We assessed markers of MBD in patients with well-functioning kidney transplants to minimise confounding by reduced transplant function. Methods: In this cross-sectional study, 40 patients aged R18 years who received a first kidney transplant more than 10 years ago were included. A well-functioning transplant was defined as an estimated glomerular filtration rate (eGFR) R45 ml/min per 1.73 m 2 .

Kidney transplantation and bone disease: risk factors of development and diagnostics

“…При удовлетворительной функции почечного транс плантата сывороточная концентрация ФРФ23 по степенно снижается, приближаясь к физиологиче скому уровню к концу первого года после операции [8][9][10]. В отдаленном посттрансплантационном пе риоде определяется повышенный уровень ФРФ23 в сравнении с пациентами с соответствующей стади ей ХБП, нарастание его уровня происходит парал лельно утрате функции почки [11][12][13]. Паратиреоидный гормон.…”

“…Посттрансплантационный гиперпаратиреоз (ГПТ) диагностируется у 10-66% пациентов, зна чительно чаще в первый год и существенно реже в последующие годы [10,[12][13][14]. Такой большой разброс частоты ГПТ связан как с использовани ем различных целевых значений ПТГ, так и об следованием пациентов в различные сроки после трансплантации почки.…”

“…Выраженность гипофосфате мии различна -от умеренной (1,5-2,3 мг/дл) до выраженной (<1,5 мг/дл). В целом сывороточная концентрация фосфора у реципиентов почечного трансплантата ниже, чем у больных и сопостави мой стадией ХБП [9,12,13,41].…”

Arterial Calcification in Chronic Kidney Disease: Whom? When? and How to Handle?

“…Such patients should continue the anti-calcific measures applied to CKD G3 patients. This advice is based on the previous observation of the strong association between baseline CAC score and CAC progression [147] and on the recent finding of high serum level FGF23 in KTRs even when they have normal graft function [148]. This disturbance of FGF23 appeared to be related to the endothelial cell injury in KTRs [149].…”

Persistent hyperparathyroidism after kidney transplantation; updates on the risk factors and its complications

“…Interestingly, even with satisfactory allograft function, a notable proportion of kidney transplant recipients continue to have elevated PTH levels (1). In longterm kidney transplant recipients with a considerably functioning allograft, with estimated glomerular filtration rate (eGFR) greater than 30 to 45 mL/min, elevated PTH level can still be found in 30% to 60% at one-year following transplantation (3)(4)(5)(6)(7)(8), and about 20% of patients have persistently elevated PTH levels at five years after kidney transplantation (9), resulting in persistent secondary HPT or progresses to tertiary HPT post-transplantation (6,10). Thus, Kidney Disease Outcomes Quality Initiative (KDOQI) guideline has suggested early and routine monitoring of PTH (monthly through the first 3 months, and once every 3 months from 3 months to 1 year after transplantation) (11).…”