{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:30:26Z","timestamp":1753878626543,"version":"3.41.2"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Post\u2010transplant hyperparathyroidism (PT\u2010HPT) is common in kidney transplant recipients (KTRs) and can cause nephrocalcinosis and graft dysfunction. Cinacalcet is commonly used for treating PT\u2010HPT but may induce calciuria and exacerbate nephrocalcinosis. The concurrent use of bisphosphonates with cinacalcet to prevent this complication has not been reported. We report a case of PT\u2010HPT\u2010associated graft dysfunction. The patient had ESRD due to IgAN. She had been on continuous ambulatory peritoneal dialysis (CAPD) for 7\u2009years before undergoing kidney transplantation (KT). Pre\u2010KT intact parathyroid hormone (iPTH) was 101\u2009pmol\/L, alkaline phosphatase (ALP) 205\u2009IU\/L, Ca 2.40\u2009mmol\/L and PO4 2.2\u2009mmol\/L. There was immediate graft function after KT and the existence of persistent hyperparathyroidism (Cr 72\u2009\u03bcmol\/L, eGFR &gt; 60\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>, Ca 2.85\u2009mmol\/L, PO4 0.6\u2009mmol\/L, ALP 315\u2009IU\/L, iPTH 16.4\u2009pmol\/L). Progressive renal impairment ensued over the next 10\u2009months (Cr 146\u2009\u03bcmol\/L, eGFR 34\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>, Ca 2.77\u2009mmol\/L, PO4 0.9\u2009mmol\/L, ALP 142\u2009IU\/L, iPTH 24.4\u2009pmol\/L). Graft biopsy at 10\u2009months post\u2010KT revealed widespread tubular calcifications and no evidence of rejection. Intravenous pamidronate 60\u2009mg was given quarterly for 3 doses in addition to cinacalcet therapy. ALP decreased from 147 to 81\u2009IU\/L despite refractory PT\u2010HPT and renal function improved. Total parathyroidectomy was performed 1\u2009month after the last pamidronate dose. Renal function remained stable for up to 4\u2009years post\u2010KT (Cr 151\u2009\u03bcmol\/L, eGFR 33\u2009mL\/min\/1.73\u2009m<jats:sup>2<\/jats:sup>, Ca 2.19\u2009mmol\/L, PO4 1.3\u2009mmol\/L, ALP 70\u2009IU\/L, iPTH &lt;\u20090.1\u2009pmol\/L). Our case report highlights the therapeutic potential of pamidronate in addition to cinacalcet in the management of PT\u2010HPT\u2010associated nephrocalcinosis.<\/jats:p>","DOI":"10.1111\/nep.14415","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T06:58:51Z","timestamp":1733813931000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bisphosphonate therapy for persistent hyperparathyroidism after kidney transplantation\u2014A case report"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6625-8536","authenticated-orcid":false,"given":"Ho\u2010Kwan","family":"Sin","sequence":"first","affiliation":[{"name":"Kwong Wah Hospital  Kowloon Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kin\u2010Yee","family":"Lo","sequence":"additional","affiliation":[{"name":"Kwong Wah Hospital  Kowloon Hong 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