Prytula, Agnieszka ORCID: 0000-0001-9551-8758, Shroff, Rukshana ORCID: 0000-0001-8501-1072, Krupka, Kai, Deschepper, Ellen, Bacchetta, Justine, Ariceta, Gema, Awan, Atif ORCID: 0000-0002-1615-2602, Benetti, Elisa, Buescher, Anja, Berta, Laszlo, Carraro, Andrea, Christian, Martin, Dello Strologo, Luca, Doerry, Katja, Haumann, Sophie, Klaus, Guenter, Kempf, Caroline, Kranz, Birgitta, Oh, Jun, Pape, Lars, Pohl, Martin, Printza, Nikoleta, Rubik, Jacek, Schmitt, Claus Peter, Shenoy, Mohan, Sparta, Giuseppina, Staude, Hagen, Sweeney, Clodagh, Weber, Lutz, Weber, Stefanie, Weitz, Marcus, Haffner, Dieter and Toenshoff, Burkhard (2022). Hyperparathyroidism Is an Independent Risk Factor for Allograft Dysfunction in Pediatric Kidney Transplantation. Kidney Int. Rep., 8 (1). S. 81 - 91. NEW YORK: ELSEVIER SCIENCE INC. ISSN 2468-0249

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Abstract

Introduction: Little is known about the consequences of deranged chronic kidney disease-mineral and bone disorder (CKD-MBD) parameters on kidney allograft function in children. We examined a relationship between these parameters over time and allograft outcome. Methods: This registry study from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) collected data at baseline, months 1, 3, 6, 9, and 12 after transplant; and every 6 months thereafter up to 5 years. Survival analysis for a composite end point of graft loss or estimated glomerular filtration rate (eGFR) #30 ml/min per 1.73 m2 or a $50% decline from eGFR at month 1 posttransplant was performed. Associations of parathyroid hormone (PTH), calcium, phosphate, and 25-hydroxyvitamin D (25(OH)D) with allograft outcome were investigated using conventional stratified Cox proportional hazards models and further verified with marginal structural models with time-varying covariates. Results: We report on 1210 patients (61% boys) from 16 European countries. The composite end point was reached in 250 grafts (21%), of which 11 (4%) were allograft losses. In the conventional Cox proportional hazards models adjusted for potential confounders, only hyperparathyroidism (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.82-4.74) and hyperphosphatemia (HR, 1.94; 95% CI, 1.28-2.92) were associated with the composite end point. Marginal structural models showed similar results for hyperparathyroidism (HR, 2.74; 95% CI, 1.71-4.38), whereas hyperphosphatemia was no longer significant (HR, 1.35; 95% CI, 0.87- 2.09), suggesting that its association with graft dysfunction can be ascribed to a decline in eGFR. Conclusion: Hyperparathyroidism is a potential independent risk factor for allograft dysfunction in children.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Prytula, AgnieszkaUNSPECIFIEDorcid.org/0000-0001-9551-8758UNSPECIFIED
Shroff, RukshanaUNSPECIFIEDorcid.org/0000-0001-8501-1072UNSPECIFIED
Krupka, KaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deschepper, EllenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bacchetta, JustineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ariceta, GemaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Awan, AtifUNSPECIFIEDorcid.org/0000-0002-1615-2602UNSPECIFIED
Benetti, ElisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buescher, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berta, LaszloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Carraro, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Christian, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dello Strologo, LucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerry, KatjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haumann, SophieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klaus, GuenterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kempf, CarolineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kranz, BirgittaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oh, JunUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pape, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pohl, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Printza, NikoletaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rubik, JacekUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmitt, Claus PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shenoy, MohanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sparta, GiuseppinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Staude, HagenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sweeney, ClodaghUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, StefanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weitz, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Haffner, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Toenshoff, BurkhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-697720
DOI: 10.1016/j.ekir.2022.10.018
Journal or Publication Title: Kidney Int. Rep.
Volume: 8
Number: 1
Page Range: S. 81 - 91
Date: 2022
Publisher: ELSEVIER SCIENCE INC
Place of Publication: NEW YORK
ISSN: 2468-0249
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MINERAL METABOLISM; GRAFT FAILURE; RENAL-TRANSPLANT; EUROPEAN-SOCIETY; VITAMIN-D; CKD-MBD; CHILDREN; CALCIFICATION; PROGRESSION; DIALYSISMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69772

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