{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:59:14Z","timestamp":1780635554866,"version":"3.54.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Controversies exist whether disturbances in mineral and bone disorder (MBD) normalise or persist after kidney transplantation. We assessed markers of MBD in patients with well-functioning kidney transplants to minimise confounding by reduced transplant function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cross-sectional study, 40 patients aged \u226518 years who received a first kidney transplant more than 10 years ago were included. A well-functioning transplant was defined as an estimated glomerular filtration rate (eGFR) \u226545\u200aml\/min per 1.73\u200am<jats:sup>2<\/jats:sup>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median time since transplantation was 18.3 years (inter quartile range (IQR) 12.2\u201326.2). Albumin-corrected serum calcium levels were above upper limit of normal in 15% of the transplanted patients, and serum phosphate levels below lower limit of normal in 31%. The median levels of intact parathyroid hormone (iPTH) and intact fibroblast growth factor 23 (iFGF23) were significantly higher than that in a group of healthy volunteers (11.3\u200apmol\/l (IQR: 8.7\u201316.2) vs 4.4\u200apmol\/l (IQR: 3.8\u20135.9), <jats:italic>P<\/jats:italic>&lt;0.001 and 75.0\u200apg\/ml (IQR: 53.3\u2013108.0) vs 51.3\u200apg\/ml (IQR: 36.3\u201367.6), <jats:italic>P<\/jats:italic>=0.004 respectively). There was a non-significant reduction in soluble Klotho (sKlotho) levels (605\u200apg\/ml (IQR: 506\u2013784) vs 692\u200apg\/ml (IQR: 618\u2013866)). When compared with a control group matched for eGFR, levels of iPTH were significantly higher (<jats:italic>P<\/jats:italic>&lt;0.001), iFGF23 had a non-significant trend towards higher levels and sKlotho towards lower levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In long-term kidney transplant patients with well-functioning kidney transplants, we found inappropriately high levels of iPTH and iFGF23 consistent with a state of persistent hyperparathyroidism. We speculate that the primary defect, FGF23 resistance, has evolved in the parathyroid gland before transplantation, and persists due to long half-life of the parathyroid cells.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-14-0457","type":"journal-article","created":{"date-parts":[[2015,1,9]],"date-time":"2015-01-09T02:09:19Z","timestamp":1420769359000},"page":"343-350","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":27,"title":["Soluble Klotho and intact fibroblast growth factor 23 in long-term kidney transplant patients"],"prefix":"10.1093","volume":"172","author":[{"given":"Inger H","family":"Bleskestad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga 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