Journal of Clinical Endocrinology & Metabolism, Vol 72, 350-355, Copyright © 1991 by Endocrine Society

ARTICLES

Parathyroid function in normocalcemic renal transplant recipients: evaluation by calcium infusion

BH Mitlak, M Alpert, C Lo, F Delmonico and RM Neer
Endocrine Unit, Massachusetts General Hospital, Boston 02114.

The extent to which secondary hyperparathyroidism may involute remains poorly defined. Renal transplantation offers a clinical situation in which metabolic stimuli for hyperparathyroidism are removed. To examine whether hyperparathyroidism resolves after transplantation, we evaluated 11 renal transplant recipients who had been normocalcemic 6 or more months after transplantation using a sensitive 2-site immunoradiometric assay for intact serum PTH. Nine of the 11 had PTH concentrations within the normal range. Of these 9, 6 were found to have abnormal parathyroid function when challenged with an iv calcium infusion. The other 2 patients demonstrated significantly elevated basal PTH concentrations and elevated ionized calcium despite normal total serum calcium and albumin concentrations. In both, the PTH response to infused calcium was markedly abnormal, confirming hyperparathyroidism. The estimated renal threshold phosphate concentration was low in 4 of 9 patients with normal basal PTH concentrations and in both with elevated basal PTH. Bone mineral density, measured at the radius by single photon absorptiometry and at the spine by dual energy x-ray absorptiometry, was normal in 8 of the 9 transplant recipients who had normal basal PTH concentrations.

This article has been cited by other articles:

				A. Schwarz, G. Rustien, S. Merkel, J. Radermacher, and H. Haller Decreased renal transplant function after parathyroidectomy Nephrol. Dial. Transplant., February 1, 2007; 22(2): 584 - 591. [Abstract] [Full Text] [PDF]