Abstract

Early Post Kidney Transplantation Hypophosphatemia

Background: Hypophosphatemia is one of the common complications after kidney transplantation (Tx). This study aimed to investigate the prevalence of hypophosphatemia in early post kidney Tx period and the associated risk factors. Methods: Fifty renal transplant recipients were studied for serum phosphate (Pi) level on the day before (-1) and on 10 and 30 days after kidney Tx. Levels of serum creatinine (Cr), Pi, 25-hydroxyvitamin D (25(OH)D), intact PTH (iPTH) and FGF-23 and the 24 hour urinary excretion of Pi and Cr, estimated Glomerular Filtration Rate (eGFR) and the ratio of transport maximum of Pi to eGFR (TMP/GFR) were measured on the same days. Results: Hypophosphatemia (serum Pi < 2.5 mg/dl) was observed in 0%, 40% and 42% of the patients On days -1, +10 and +30, respectively. There was no significant difference between 25(OH)D and iPTH levels in patients with and without hypophosphatemia on days +10 and +30. Pre-Tx FGF-23 level was significantly higher in patients with hypophosphatemia on days +10 and +30, compared to those with normophosphatemia in the same days(p=0.01 and p=0.04, respectively). Regression coefficient of TMP/GFR and Cr were positive on days -1 (p=0.01), +10 (p=0.001) and +30 (p=0.001). Coefficient of pre-Tx FGF-23 on post- Tx serum Pi was negative on days +10 (p=0.03)and +30 (p=0.003) and coefficient of post-Tx FGF-23 on day +10 with serum Pi was negative(p=0.008). Conclusion: The main determinants of post-Tx hypophosphatemia in multivariate linear analysis were pre- Tx FGF-23, post-Tx FGF-23 levels on days +10, post-Tx Cr,


Author(s): Maryam Ghorbani and Shahrzad Ossareh

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