Evidence map›Paper›PMID 34266650›Full record

Observational studySurgery2022

Prevalence and risk factors for tertiary hyperparathyroidism in kidney transplant recipients.

Whitney Sutton, Xiaomeng Chen, Palak Patel, Shkala Karzai, Jason D Prescott, Dorry L Segev, Mara McAdams-DeMarco, Aarti Mathur

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
38citing papers in PubMed, 3 pooled it
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 57 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Whitney SuttonDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: wsutton9@jhmi.edu.
Xiaomeng ChenDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Palak PatelDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Shkala KarzaiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Jason D PrescottDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Dorry L SegevDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Mara McAdams-DeMarcoDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Aarti MathurDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Johns Hopkins University · US

Funding

Clinical and Laboratory Research Training for Surgical OncologistsT32CA126607 · NCI · JOHNS HOPKINS UNIVERSITY · PI CAMERON, ANDREW M. · 2008 to 2024
$6.0M
Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
Hemodialysis-based interventions to preserve cognitive functionR01DK114074 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2018 to 2022
$3.9M
Developing personalized immunosuppression for older kidney transplant recipientsR01DK120518 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2019 to 2022
$2.7M
Reducing geographic disparities in kidney and liver allocationR01DK111233 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI WARREN, DANIEL S · 2016 to 2019
$2.5M
Association of Fraility with Post thyroidectomy alterations in Voice, Swallowing, and Quality of LifeK23AG053429 · NIA · JOHNS HOPKINS UNIVERSITY · PI MATHUR, AARTI · 2017 to 2022
$1.0M
Patient Oriented Research in Solid Organ TransplantationK24AI144954 · NIAID · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI SEGEV, DORRY L. · 2020 to 2024
$956k
NCI NIH HHS T32 CA126607NIAID NIH HHS K24 AI144954NIA NIH HHS K23 AG053429NIA NIH HHS R01 AG055781NIDDK NIH HHS R01 DK111233NIDDK NIH HHS R01 DK114074NIDDK NIH HHS R01 DK120518
6 · The paper itself

Abstract

backgroundTertiary hyperparathyroidism after kidney transplantation has been associated with graft dysfunction, cardiovascular morbidity, and osteopenia; however, its true prevalence is unclear. The objective of our study was to evaluate the prevalence of and risk factors for tertiary hyperparathyroidism.

methodsA prospective cohort of 849 adult kidney transplantation recipients (December 2008-February 2020) was used to estimate the prevalence of hyperparathyroidism 1-year post-kidney transplant. Tertiary hyperparathyroidism was defined as hypercalcemia (≥10mg/dL) and hyperparathyroidism (parathyroid hormone≥70pg/mL) 1-year post-kidney transplantation. Modified Poisson regression models were used to evaluate risk factors associated with the development of both persistent hyperparathyroidism and tertiary hyperparathyroidism.

resultsAmong kidney transplantation recipients, 524 (61.7%) had persistent hyperparathyroidism and 182 (21.5%) had tertiary hyperparathyroidism at 1-year post-kidney transplantation. Calcimimetic use before kidney transplantation was associated with 1.30-fold higher risk of persistent hyperparathyroidism (adjusted prevalence ratio = 1.30, 95% CI: 1.12-1.51) and 1.84-fold higher risk of tertiary hyperparathyroidism (adjusted prevalence ratio = 1.84, 95% CI: 1.25-2.72). Pre-kidney transplantation parathyroid hormone ≥300 pg/mL was associated with 1.49-fold higher risk of persistent hyperparathyroidism (adjusted prevalence ratio = 1.49, 95% CI = 1.19-1.85) and 2.21-fold higher risk of tertiary hyperparathyroidism (adjusted prevalence ratio = 2.21, 95% CI = 1.25-3.90). Pre-kidney transplantation tertiary hyperparathyroidism was associated with an increased risk of post-kidney transplantation tertiary hyperparathyroidism (adjusted prevalence ratio = 1.71, 95% CI = 1.29-2.27), but not persistent hyperparathyroidism. Furthermore, 73.0% of patients with persistent hyperparathyroidism and 61.5% with tertiary hyperparathyroidism did not receive any treatment at 1-year post-kidney transplantation.

conclusionPersistent hyperparathyroidism affected 61.7% and tertiary hyperparathyroidism affected 21.5% of kidney transplantation recipients; however, the majority of patients were not treated. Pre-kidney transplantation parathyroid hormone levels ≥300pg/mL and the use of calcimimetics are associated with the development of tertiary hyperparathyroidism. These findings encourage the re-evaluation of recommended pre-kidney transplantation parathyroid hormone thresholds and reconsideration of pre-kidney transplantation secondary hyperparathyroidism treatments to avoid the adverse sequelae of tertiary hyperparathyroidism in kidney transplantation recipients.

Indexed as

AdultAgedCalciumFemaleHumansHypercalcemiaHyperparathyroidismKidney Failure, ChronicKidney TransplantationMaleMiddle AgedParathyroid HormonePostoperative ComplicationsPrevalenceProspective StudiesRisk FactorsCalciumParathyroid Hormone

Identifiers

PMID34266650
PMCPMC8688275
OpenAlexW3181045413

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.