{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T20:06:35Z","timestamp":1787083595756,"version":"build-2736575974"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Nephrol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Long-term dialysis vintage is a predictor of persistent hyperparathyroidism (HPT) after kidney transplantation (KTx). Recently, preemptive kidney transplantation (PKT) has increased. However, the incidence, predictors, and clinical implications of HPT after PKT are unclear. Here, we aimed to elucidate these considerations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this retrospective cohort study, we enrolled patients who underwent PKT between 2000 and 2016. Those who lost their graft within 1\u00a0year posttransplant were excluded. HPT was defined as an intact parathyroid hormone (PTH) level exceeding 80\u00a0pg\/mL or hypercalcemia unexplained by causes other than HPT. Patients were divided into two groups based on the presence of HPT 1\u00a0year after PKT. The primary outcome was the predictors of HPT after PKT, and the secondary outcome was graft survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 340 consecutive patients who underwent PKT, 188 did not have HPT (HPT-free group) and 152 had HPT (HPT group). Multivariate logistic regression analysis revealed that pretransplant PTH level (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; odds ratio [OR], 5.480; 95% confidence interval [CI], 2.070\u201314.50) and preoperative donor-estimated glomerular filtration rate (<jats:italic>P<\/jats:italic>\u2009=\u20090.033; OR, 0.978; 95% CI, 0.957\u20130.998) were independent predictors of HPT after PKT. Death-censored graft survival was significantly lower in the HPT group than that in the HPT-free group (90.4% vs. 96.4% at 10\u00a0years,<jats:italic>P<\/jats:italic>\u2009=\u20090.009).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pretransplant PTH levels and donor kidney function were independent predictors of HPT after PKT. In addition, HPT was associated with worse graft outcomes even after PKT.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s10157-023-02371-9","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T21:29:35Z","timestamp":1687555775000},"page":"882-889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Persistent hyperparathyroidism after preemptive kidney transplantation"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8446-7841","authenticated-orcid":false,"given":"Manabu","family":"Okada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuhiko","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Futamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahisa","family":"Hiramitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Ichimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Goto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunji","family":"Narumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asami","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Watarai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,23]]},"reference":[{"issue":"8","key":"2371_CR1","doi-asserted-by":"publisher","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","volume":"15","author":"GA Block","year":"2004","unstructured":"Block GA, Klassen PS, Lazarus JM, Ofsthun N, Lowrie EG, Chertow GM. Mineral metabolism, mortality, and morbidity in maintenance hemodialysis. J Am Soc Nephrol. 2004;15(8):2208\u201318.","journal-title":"J Am Soc Nephrol"},{"issue":"2","key":"2371_CR2","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1093\/oxfordjournals.ndt.a027843","volume":"13","author":"W Reinhardt","year":"1998","unstructured":"Reinhardt W, Bartelworth H, Jockenh\u00f6vel F, Schmidt-Gayk H, Witzke O, Wagner K, et al. Sequential changes of biochemical bone parameters after kidney transplantation. Nephrol Dial Transplant. 1998;13(2):436\u201342.","journal-title":"Nephrol Dial Transplant"},{"issue":"2","key":"2371_CR3","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/TP.0000000000000583","volume":"99","author":"H Pihlstr\u00f8m","year":"2015","unstructured":"Pihlstr\u00f8m H, Dahle DO, Mj\u00f8en G, Pilz S, M\u00e4rz W, Abedini S, et al. Increased risk of all-cause mortality and renal graft loss in stable renal transplant recipients with hyperparathyroidism. Transplantation. 2015;99(2):351\u20139.","journal-title":"Transplantation"},{"issue":"1","key":"2371_CR4","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.transproceed.2019.11.020","volume":"52","author":"NG Kirnap","year":"2020","unstructured":"Kirnap NG, Kirnap M, Sayin B, Akdur A, Bascil Tutuncu N, Haberal M. Risk factors and treatment options for persistent hyperparathyroidism after kidney transplantation. Transplant Proc. 2020;52(1):157\u201361.","journal-title":"Transplant Proc"},{"issue":"3","key":"2371_CR5","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1007\/s00268-015-3314-z","volume":"40","author":"T Yamamoto","year":"2016","unstructured":"Yamamoto T, Tominaga Y, Okada M, Hiramitsu T, Tsujita M, Goto N, et al. Characteristics of persistent hyperparathyroidism after renal transplantation. World J Surg. 2016;40(3):600\u20136.","journal-title":"World J Surg"},{"issue":"3","key":"2371_CR6","doi-asserted-by":"publisher","first-page":"497","DOI":"10.2215\/CJN.08670815","volume":"11","author":"N Goto","year":"2016","unstructured":"Goto N, Okada M, Yamamoto T, Tsujita M, Hiramitsu T, Narumi S, et al. Association of dialysis duration with outcomes after transplantation in a Japanese cohort. Clin J Am Soc Nephrol. 2016;11(3):497\u2013504.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"11","key":"2371_CR7","doi-asserted-by":"publisher","first-page":"1353","DOI":"10.1007\/s40618-019-01075-w","volume":"42","author":"N Yalla","year":"2019","unstructured":"Yalla N, Bobba G, Guo G, Stankiewicz A, Ostlund R. Parathyroid hormone reference ranges in healthy individuals classified by vitamin D status. J Endocrinol Invest. 2019;42(11):1353\u201360.","journal-title":"J Endocrinol Invest"},{"key":"2371_CR8","doi-asserted-by":"crossref","unstructured":"Anonymous. Correcting the calcium. Br Med J. 1977,1 (6061): 598.","DOI":"10.1136\/bmj.1.6061.598"},{"issue":"6","key":"2371_CR9","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1053\/j.ajkd.2008.12.034","volume":"53","author":"S Matsuo","year":"2009","unstructured":"Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53(6):982\u201392.","journal-title":"Am J Kidney Dis"},{"issue":"9","key":"2371_CR10","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1007\/BF03347375","volume":"29","author":"A Giusti","year":"2006","unstructured":"Giusti A, Barone A, Razzano M, Pizzonia M, Oliveri M, Palummeri E, et al. High prevalence of secondary hyperparathyroidism due to hypovitaminosis D in hospitalized elderly with and without hip fracture. J Endocrinol Invest. 2006;29(9):809\u201313.","journal-title":"J Endocrinol Invest"},{"key":"2371_CR11","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1007\/s11657-014-0176-1","volume":"9","author":"R Sayed-Hassan","year":"2014","unstructured":"Sayed-Hassan R, Abazid N, Alourfi Z. Relationship between 25-hydroxyvitamin D concentrations, serum calcium, and parathyroid hormone in apparently healthy Syrian people. Arch Osteoporos. 2014;9:176.","journal-title":"Arch Osteoporos"},{"issue":"9","key":"2371_CR12","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1001\/jama.1981.03310340020020","volume":"245","author":"F Vincenti","year":"1981","unstructured":"Vincenti F, Hattner R, Amend WJ Jr, Feduska NJ, Duca RM, Salvatierra O Jr. Decreased secondary hyperparathyroidism in diabetic patients receiving hemodialysis. JAMA. 1981;245(9):930\u20133.","journal-title":"JAMA"},{"issue":"10","key":"2371_CR13","doi-asserted-by":"publisher","first-page":"e0186093","DOI":"10.1371\/journal.pone.0186093","volume":"12","author":"MD J\u00e4ger","year":"2017","unstructured":"J\u00e4ger MD, Serttas M, Beneke J, M\u00fcller JA, Schrem H, Kaltenborn A, et al. Risk-factors for nodular hyperplasia of parathyroid glands in sHPT patients. PLoS ONE. 2017;12(10):e0186093.","journal-title":"PLoS ONE"},{"issue":"6","key":"2371_CR14","doi-asserted-by":"publisher","first-page":"1631","DOI":"10.1016\/j.surg.2014.08.070","volume":"156","author":"LC Dewberry","year":"2014","unstructured":"Dewberry LC, Tata S, Graves S, Weber CJ, Sharma J. Predictors of tertiary hyperparathyroidism: Who will benefit from parathyroidectomy? Surgery. 2014;156(6):1631\u20136.","journal-title":"Surgery"},{"issue":"10","key":"2371_CR15","doi-asserted-by":"publisher","first-page":"2131","DOI":"10.1681\/ASN.V12102131","volume":"12","author":"SK Ganesh","year":"2001","unstructured":"Ganesh SK, Stack AG, Levin NW, Hulbert-Shearon T, Port FK. Association of elevated serum PO(4), Ca x PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients. J Am Soc Nephrol. 2001;12(10):2131\u20138.","journal-title":"J Am Soc Nephrol"},{"issue":"1","key":"2371_CR16","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.surg.2021.03.067","volume":"171","author":"W Sutton","year":"2022","unstructured":"Sutton W, Chen X, Patel P, Karzai S, Prescott JD, Segev DL, et al. Prevalence and risk factors for tertiary hyperparathyroidism in kidney transplant recipients. Surgery. 2022;171(1):69\u201376.","journal-title":"Surgery"},{"issue":"3","key":"2371_CR17","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y. Investigation of the freely available easy-to-use software \u201cEZR\u201d for medical statistics. Bone Marrow Transplant. 2013;48(3):452\u20138.","journal-title":"Bone Marrow Transplant"},{"issue":"5","key":"2371_CR18","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1007\/s00423-009-0534-4","volume":"394","author":"R Mihai","year":"2009","unstructured":"Mihai R, Simon D, Hellman P. Imaging for primary hyperparathyroidism\u2013an evidence-based analysis. Langenbecks Arch Surg. 2009;394(5):765\u201384.","journal-title":"Langenbecks Arch Surg"},{"issue":"4","key":"2371_CR19","doi-asserted-by":"publisher","first-page":"576","DOI":"10.3109\/0886022X.2015.1007805","volume":"37","author":"L Jinfeng","year":"2015","unstructured":"Jinfeng L, Jia L, Tao G, Wenjun S, Xinlu P, Yonghua F, et al. Donor kidney glomerular filtration rate and donor\/recipient body surface area ratio influence graft function in living related kidney transplantation. Ren Fail. 2015;37(4):576\u201381.","journal-title":"Ren Fail"},{"issue":"4","key":"2371_CR20","first-page":"169","volume":"70","author":"Y Zheng","year":"2018","unstructured":"Zheng Y, Guan Y, Li Z, Zhang G, Guo Y, Ai X. Roles of donor\/recipient body surface area ratio and donor kidney glomerular filtration rate in kidney selection for living transplantation from family members. Rev Invest Clin. 2018;70(4):169\u201376.","journal-title":"Rev Invest Clin"},{"issue":"4","key":"2371_CR21","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1053\/j.ajkd.2011.04.029","volume":"58","author":"P Ure\u00f1a-Torres","year":"2011","unstructured":"Ure\u00f1a-Torres P, Metzger M, Haymann JP, Karras A, Boffa JJ, Flamant M, et al. Association of kidney function, vitamin D deficiency, and circulating markers of mineral and bone disorders in CKD. Am J Kidney Dis. 2011;58(4):544\u201353.","journal-title":"Am J Kidney Dis"},{"issue":"5","key":"2371_CR22","doi-asserted-by":"publisher","first-page":"810","DOI":"10.2215\/CJN.08680811","volume":"7","author":"C Nakano","year":"2012","unstructured":"Nakano C, Hamano T, Fujii N, Matsui I, Tomida K, Mikami S, et al. Combined use of vitamin D status and FGF23 for risk stratification of renal outcome. Clin J Am Soc Nephrol. 2012;7(5):810\u20139.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"5","key":"2371_CR23","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1016\/j.surg.2017.12.010","volume":"163","author":"M Araujo","year":"2018","unstructured":"Araujo M, Ramalho JAM, Elias RM, Jorgetti V, Nahas W, Custodio M, et al. Persistent hyperparathyroidism as a risk factor for long-term graft failure: the need to discuss indication for parathyroidectomy. Surgery. 2018;163(5):1144\u201350.","journal-title":"Surgery"},{"key":"2371_CR24","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12882-022-02840-5","volume":"23","author":"M Okada","year":"2022","unstructured":"Okada M, Tominaga Y, Sato T, Tomosugi T, Futamura K, Hiramitsu T, et al. Elevated parathyroid hormone one year after kidney transplantation is an independent risk factor for graft loss even without hypercalcemia. BMC Nephrol. 2022;23:212.","journal-title":"BMC Nephrol"},{"issue":"1","key":"2371_CR25","doi-asserted-by":"publisher","first-page":"408","DOI":"10.3390\/ijms22010408","volume":"22","author":"S Panizo","year":"2021","unstructured":"Panizo S, Mart\u00ednez-Arias L, Alonso-Montes C, Cannata P, Mart\u00edn-Carro B, Fern\u00e1ndez-Mart\u00edn JL, et al. Fibrosis in chronic kidney disease: pathogenesis and consequences. Int J Mol Sci. 2021;22(1):408.","journal-title":"Int J Mol Sci"},{"key":"2371_CR26","doi-asserted-by":"crossref","first-page":"128352","DOI":"10.1155\/2012\/128352","volume":"2012","author":"LM Amaral","year":"2012","unstructured":"Amaral LM, Queiroz DC, Marques TF, Mendes M, Bandeira F. Normocalcemic versus Hypercalcemic Primary Hyperparathyroidism: More Stone than Bone? J Osteoporos. 2012;2012:128352.","journal-title":"J Osteoporos"},{"issue":"2","key":"2371_CR27","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1007\/s00268-019-05124-6","volume":"44","author":"M Okada","year":"2020","unstructured":"Okada M, Hiramitsu T, Ichimori T, Goto N, Narumi S, Watarai Y, et al. Comparison of pre- and post-transplant parathyroidectomy in renal transplant recipients and the impact of parathyroidectomy timing on calcium metabolism and renal allograft function: a retrospective single-center analysis. World J Surg. 2020;44(2):498\u2013507.","journal-title":"World J Surg"},{"key":"2371_CR28","doi-asserted-by":"publisher","first-page":"115699","DOI":"10.1016\/j.bone.2020.115699","volume":"143","author":"S Salam","year":"2021","unstructured":"Salam S, Gallagher O, Gossiel F, Paggiosi M, Eastell R, Khwaja A. Vascular calcification relationship to vascular biomarkers and bone metabolism in advanced chronic kidney disease. Bone. 2021;143:115699.","journal-title":"Bone"},{"key":"2371_CR29","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.3390\/ijms21082685","volume":"21","author":"SJ Lee","year":"2020","unstructured":"Lee SJ, Lee IK, Jeon JH. Vascular calcification\u2014new insights into its mechanism. Int J Mol Sci. 2020;21:2685.","journal-title":"Int J Mol Sci"},{"issue":"4","key":"2371_CR30","first-page":"e200","volume":"2023","author":"W Pan","year":"2020","unstructured":"Pan W, Jie W, Huang H. Vascular calcification: Molecular mechanisms and therapeutic interventions. MedComm. 2020;2023(4):e200.","journal-title":"MedComm"}],"container-title":["Clinical and Experimental Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10157-023-02371-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10157-023-02371-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10157-023-02371-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T15:44:53Z","timestamp":1702655093000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10157-023-02371-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,23]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["2371"],"URL":"https:\/\/doi.org\/10.1007\/s10157-023-02371-9","relation":{},"ISSN":["1342-1751","1437-7799"],"issn-type":[{"value":"1342-1751","type":"print"},{"value":"1437-7799","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,23]]},"assertion":[{"value":"10 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors have declared that no conflict of interest exists.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Board (IRB) of the Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital (IRB approval number: 1471) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"An informed consent waiver was obtained from the IRB of Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital. Details regarding the study and its opt-outs are provided in detail on our institutional website.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}}]}}