Traindl O, Längle F, Reading S, Franz M, Watschinger B, Klauser R, Woloszczuk W, Kovarik J
Department of Internal Medicine III, University of Vienna, Austria.
Nephrol Dial Transplant. 1993;8(2):173-6.
In the present study we investigated the relationship between secondary hyperparathyroidism in renal graft recipients and post-transplantation acute tubular necrosis (ATN). Patients were divided into two groups according to graft function: group A consisted of 28 patients who had an uneventful postoperative period and did not require haemodialysis. Group B comprised 26 patients with primary non-function of the graft due to biopsy-proven ATN who required continued haemodialysis for the first postoperative week or longer (mean 14.2 +/- 8.7 days). Both groups had comparable donor characteristics, HLA-matching and ischaemia times. All patients were given cyclosporin and low-dose prednisolone for immunosuppression. Pretransplant levels of intact PTH were significantly greater in group B than in group A (203.5 +/- 193.1 pg/ml versus 81.7 +/- 45.2 pg/ml, P < 0.01). Group B patients had more transplant biopsies (50 versus 7) and a longer hospitalization time (33.4 +/- 10.9 days versus 21.9 +/- 11.9 days, P < 0.01), although serum creatinine on the day of discharge was higher in group B (1.77 +/- 0.51 mg/dl versus 1.5 +/- 0.45 mg/dl, P < 0.05). We conclude that patients with secondary hyperparathyroidism as assessed by measuring circulating levels of intact PTH have an increased incidence of ATN.
在本研究中，我们调查了肾移植受者继发性甲状旁腺功能亢进与移植后急性肾小管坏死（ATN）之间的关系。根据移植肾功能将患者分为两组：A组由28例术后病程平稳且无需血液透析的患者组成。B组包括26例因经活检证实的ATN导致移植肾原发性无功能的患者，这些患者术后第一周或更长时间（平均14.2±8.7天）需要持续血液透析。两组患者的供体特征、HLA配型和缺血时间具有可比性。所有患者均接受环孢素和小剂量泼尼松龙进行免疫抑制。B组移植前完整甲状旁腺激素（PTH）水平显著高于A组（203.5±193.1 pg/ml对81.7±45.2 pg/ml，P<0.01）。B组患者接受的移植肾活检更多（50次对7次），住院时间更长（33.4±10.9天对21.9±11.9天，P<0.01），尽管B组出院当天的血清肌酐水平更高（1.77±0.51 mg/dl对1.5±0.45 mg/dl，P<0.05）。我们得出结论，通过测量循环中完整PTH水平评估为继发性甲状旁腺功能亢进的患者发生ATN的几率增加。
