Objective. Persistence of hyperparathyroidism (HPT) after renal transplantation leads to undesirable outcomes such as increase in cardiovascular events, graft dysfunction, and increased mortality. Options for therapy include medical management with calcimimetic or operative management. The present study was undertaken to evaluate the natural history of HPT after renal transplantation and to determine risk factors for persistent HPT in the era of calcimimetic. Design. The study is a retrospective review of data from 74 consecutive patients who underwent renal transplantation at our institution from April 2011 to November 2019. Methods. The natural history of HPT after renal transplantation and associations between intact parathyroid hormone (PTH) level after transplantation and clinical variables such as age, sex, duration of pretransplant dialysis, and use of calcimimetic before transplantation were evaluated. Results. Intact PTH decreased after renal transplantation in most of the patients without receiving parathyroidectomy. Known risk factors of persistent HPT did not associate with intact PTH level after renal transplantation in patients who had been receiving calcimimetic before transplantation. Conclusion. In conclusion, we have found that HPT after renal transplantation could be managed successfully by medical treatments. When predicting the prognosis of HPT after transplantation, pretransplant use of calcimimetic should be taken into consideration.

中文翻译：

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移植前使用拟钙剂对肾移植术后甲状旁腺功能的影响

客观。肾移植后甲状旁腺功能亢进（HPT）的持续存在会导致不良后果，例如心血管事件增加、移植物功能障碍和死亡率增加。治疗选择包括使用拟钙剂或手术治疗的药物治疗。本研究旨在评估肾移植后 HPT 的自然史，并确定拟钙剂时代持续 HPT 的危险因素。设计。该研究是对 2011 年 4 月至 2019 年 11 月在我院连续接受肾移植的 74 例患者的数据进行回顾性分析。方法. 评估了肾移植后 HPT 的自然史以及移植后完整的甲状旁腺激素 (PTH) 水平与临床变量（如年龄、性别、移植前透析持续时间和移植前钙剂的使用）之间的关联。结果。大多数未接受甲状旁腺切除术的患者在肾移植后完整的 PTH 降低。在移植前接受拟钙剂的患者中，已知的持续性 HPT 危险因素与肾移植后完整的 PTH 水平无关。结论. 总之，我们发现肾移植后的HPT可以通过药物治疗成功控制。在预测移植后 HPT 的预后时，应考虑移植前使用拟钙剂。