Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function

Clin Transplant. 2014 Apr;28(4):479-86. doi: 10.1111/ctr.12341. Epub 2014 Mar 19.


Background: The aim of the study was to investigate whether serum levels of intact parathyroid hormone (iPTH) are associated with an increased risk of cardiovascular events, graft loss, or mortality in kidney transplant patients with optimal transplant function.

Methods: From the Norwegian Renal Registry, we identified 522 patients who received a first kidney transplant from 2001 to 2008 with optimal transplant function defined as an estimated glomerular filtration rate (eGFR)≥60 mL/min/1.73 m2, more than one yr after transplantation. Cox's proportional hazard models were used to assess the association between iPTH measured 10 wk after transplantation and the composite endpoint. The estimates were adjusted for age, gender, serum calcium, serum phosphate, diabetes mellitus, cardiovascular disease, and time on dialysis prior to transplantation.

Results: Median follow-up time was 3.9 yr (interquartile range, IQR: 2.0-6.0 yr). Patients in the third iPTH quartile (9.3-14.4 pM) had the lowest risk for reaching the composite endpoint. Patients in the fourth iPTH quartile (>14.4 pM) had an increased risk compared to those in the third quartile (HR: 2.60, 95% CI: 1.10-6.16, p=0.03).

Conclusion: In patients with optimal transplant function, iPTH levels are associated with a clinical outcome consisting of cardiovascular events, graft loss, and all-cause mortality.

Keywords: cardiovascular disease; chronic kidney disease mineral and bone disorder; kidney transplantation; parathyroid hormone; secondary hyperparathyroidism.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Calcium / metabolism
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / mortality
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Graft Rejection / blood*
  • Graft Rejection / etiology
  • Graft Rejection / mortality
  • Graft Survival / physiology
  • Humans
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / surgery*
  • Kidney Function Tests
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood*
  • Postoperative Complications*
  • Prognosis
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Survival Rate


  • Biomarkers
  • Parathyroid Hormone
  • Calcium