Divisão de Nefrologia, Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Divisão de Urologia, Departamento de Cirurgia, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Braz J Med Biol Res. 2021 Apr 26;54(6):e10558. doi: 10.1590/1414-431X202010558. eCollection 2021.
Hypercalcemia is common in patients after kidney transplantation (KTx) and is associated with persistent hyperparathyroidism in the majority of cases. This retrospective, single-center study evaluated the prevalence of hypercalcemia after KTx. KTx recipients were evaluated for 7 years after receiving kidneys from living or deceased donors. A total of 301 patients were evaluated; 67 patients had hypercalcemia at some point during the follow-up period. The median follow-up time for all 67 patients was 62 months (44; 80). Overall, 45 cases of hypercalcemia were classified as related to persistent post-transplant hyperparathyroidism (group A), 16 were classified as "transient post-transplant hypercalcemia" (group B), and 3 had causes secondary to other diseases (1 related to tuberculosis, 1 related to histoplasmosis, and 1 related to lymphoma). The other 3 patients had hypercalcemia of unknown etiology, which is still under investigation. In group A, the onset of hypercalcemia after KTx was not significantly different from that of the other groups, but the median duration of hypercalcemia in group A was 25 months (12.5; 53), longer than in group B, where the median duration of hypercalcemia was only 12 months (10; 15) (P<0.002). The median parathyroid hormone blood levels around 12 months after KTx were 210 pg/mL (141; 352) in group A and 72.5 pg/mL (54; 95) in group B (P<0.0001). Hypercalcemia post-KTx is not infrequent and its prevalence in this center was 22.2%. Persistent hyperparathyroidism was the most frequent cause, but other important etiologies must not be forgotten, especially granulomatous diseases and malignancies.
高钙血症在肾移植（KTx）后的患者中很常见，并且在大多数情况下与持续性甲状旁腺功能亢进症有关。这项回顾性单中心研究评估了 KTx 后高钙血症的发生率。对接受活体或已故供体肾脏的 KTx 受者进行了 7 年的评估。共评估了 301 例患者；在随访期间，有 67 例患者出现高钙血症。所有 67 例患者的中位随访时间为 62 个月（44；80）。总的来说，45 例高钙血症病例被归类为与持续性移植后甲状旁腺功能亢进症有关（A 组），16 例被归类为“移植后一过性高钙血症”（B 组），3 例有其他疾病引起的病因（1 例与结核病有关，1 例与组织胞浆菌病有关，1 例与淋巴瘤有关）。另外 3 例高钙血症病因不明，仍在调查中。在 A 组中，KTx 后高钙血症的发病时间与其他组无显著差异，但 A 组高钙血症的中位持续时间为 25 个月（12.5；53），长于 B 组，B 组高钙血症的中位持续时间仅为 12 个月（10；15）（P<0.002）。在 KTx 后约 12 个月时，A 组甲状旁腺激素血水平的中位数为 210 pg/mL（141；352），B 组为 72.5 pg/mL（54；95）（P<0.0001）。KTx 后高钙血症并不少见，本中心的患病率为 22.2%。持续性甲状旁腺功能亢进症是最常见的原因，但不能忘记其他重要的病因，特别是肉芽肿性疾病和恶性肿瘤。
