Morbidity Related to Secondary Hyperparathyroidism After Renal Transplantation

Secondary Hyperparathyroidism Related Vascular and Bone Morbidity After Renal Transplantation - a 6 Year Follow up Retrospective Cohort Study.

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT01741064

Acronym

SHPT-RT

Enrollment

257

Registered

2012-12-04

Start date

2012-02-29

Completion date

2012-10-31

Last updated

2012-12-04

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Disorder Related to Renal Transplantation, Secondary Hyperparathyroidism

Keywords

Secondary Hyperparathyroidism, Renal Transplantation, Myocardial Infarction, Fracture, Graft Failure

Brief summary

The purpose of the study is to evaluate the long term vascular morbidity and mortality in kidney transplant recipients based on one year post transplant levels of intact parathyroid hormone.

Detailed description

Secondary hyperparathyroidism (SHPT) is a well known complication to chronic renal failure. With impaired renal function the phosphate excretion from the kidney is reduced. Together with low levels of 25- and 1,25-vitamin D3 and hypocalcemia this uremic mineral milieu drives the release of parathyroid hormone (PTH) and the development of SHPT. PTH has many functions but acts mainly to release calcium from the skeleton, to enhance calcium uptake from the intestines (by actions on vitamin D) and to lower serum phosphate by inducing phosphaturia. SHPT has been shown to cause vascular morbidity and fractures in the chronic kidney disease (CKD) patient. After successful renal transplantation (RT) the mineral disturbances are mostly recovered and stabilized at one year post RT, but in recent years it has been shown that SHPT persists in the major part of RT-recipients even after long term follow up. This has been associated with high risk of fractures and vascular related morbidity in the post transplant period. It has also been shown that low levels of iPTH in the post-transplant period might be associated with a high risk of fractures. Because of insufficient data on PTH levels and associated morbidity there is no specific recommendations of target PTH levels in the RT-patient. This indicates that there is need for further observational studies to describe the SHPT-associated morbidity in a post transplant cohort based on stabilized levels of post transplant iPTH.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to 85 Years

Healthy volunteers

Inclusion criteria

* Between 18-85 years at date of transplantation * Signed informed consent or deceased at time of data collection

Design outcomes

Primary

Measure	Time frame	Description
First Vascular Event	From date of transplantation to event up to 72 months	Vascular events defined as (Myocardial infarction, Stroke, Peripheral Vascular Occlusion)

Secondary

Measure	Time frame	Description
Loss of Graft Function	From date of transplantation to event up to 72 months	Start in Active Uremic Treatment (dialysis, renal transplantation)
Overall Mortality	Fram date of transplantation to event up to 72 months	Mortality

Other

Measure	Time frame	Description
First Fracture	From date of transplantation to event up to 72 months	Fracture verified by x-ray

Outcome results