Document Detail

Low-turnover bone disease in hypercalcemic hyperparathyroidism after kidney transplantation.
MedLine Citation:
PMID:  17725680     Owner:  NLM     Status:  MEDLINE    
Hypercalcemia in persistent secondary hyperparathyroidism after kidney transplantation is considered to result from increased bone resorption. Bone biopsies' studies, however, have never been performed in these patients. Bone biopsies after double tetracycline labeling were obtained from 17 patients with hypercalcemic hyperparathyroidism and an estimated glomerular filtration rate > 30 mL/min/1.73 m2. Serologic bone markers, calcitriol, intact fibroblast growth factor-23 (iFGF-23), and serum and 24h urine concentration of calcium and phosphate were measured in all patients. Tubular maximum for phosphate corrected for GFR (TmP/GFR), and the fractional excretion of calcium (FeCa) were calculated. High-turnover renal osteodystrophy (ROD) was present in nine and low-turnover ROD in eight patients. The bone formation rate was significantly associated with bone alkaline phosphatase, c-telopeptide and osteocalcin. In patients with high turnover ROD, osteocalcin was also significantly higher than in patients with decreased bone formation. The FeCa was normal or below normal in 14/17 patients. TmP/GFR was below normal in all patients. Neither intact PTH nor iFGF-23 was associated with TmP/GFR, FeCa or any histomorphometric bone parameter. We conclude that hypercalcemia of posttransplant hyperparathyroidism can be associated with high or low turnover bone disease. Decreased calcium excretion suggests an additive tubular effect on hypercalcemia.
K Borchhardt; I Sulzbacher; T Benesch; M Födinger; G Sunder-Plassmann; M Haas
Publication Detail:
Type:  Journal Article     Date:  2007-08-24
Journal Detail:
Title:  American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons     Volume:  7     ISSN:  1600-6135     ISO Abbreviation:  Am. J. Transplant.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-11     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100968638     Medline TA:  Am J Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  2515-21     Citation Subset:  IM    
Department of Internal Medicine III, Division of Nephrology and Dialysis, Medical University of Vienna, Vienna, Austria.
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MeSH Terms
Alkaline Phosphatase / blood
Bone Diseases / etiology,  pathology,  physiopathology*
Glomerular Filtration Rate
Hypercalcemia / etiology*
Hyperparathyroidism / etiology*
Kidney Transplantation / pathology*
Middle Aged
Osteocalcin / blood
Postoperative Complications / pathology*
Renal Osteodystrophy / epidemiology
Reg. No./Substance:
104982-03-8/Osteocalcin; EC Phosphatase

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