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Article
May 1985

Management of Hypercalcemic Hyperparathyroidism After Renal Transplantation

Author Affiliations

From the Department of Surgery, St Louis University School of Medicine (Dr Garvin and Mr Linderer and Ms Dickhans); and the Transplant Unit, John Cochran Veterans Administration Medical Center, St Louis (Drs Garvin and Castaneda).

Arch Surg. 1985;120(5):578-583. doi:10.1001/archsurg.1985.01390290056009
Abstract

• To determine the optimal management of posttransplant hypercalcemia, a chart analysis of 100 stable renal allograft recipients (longer than one year) was accomplished. The incidence of hypercalcemia ranged from 12% to 20% up to 30 months after transplantation. The mean serum alkaline phosphatase level, phosphate level, and duration of dialysis in hypercalcemic patients did not differ significantly from normocalcemic patients; however, serum creatinine levels were significantly lower at 12 and 24 months in patients with hypercalcemia. In patients with hypercalcemia at three and six months, greater than 50% underwent spontaneous resolution, whereas this occurred in 25% of the patients with hypercalcemia at 12 months. Seven patients underwent parathyroidectomy with prompt resolution of their hypercalcemia and ten patients with persistent hypercalcemia have been followed up from 14 to 66 months without sequelae of hyperparathyroidism. In conclusion, hypercalcemic hyperparathyroidism is a frequent occurrence after renal transplantation. Sequelae of this condition are rare, however, and parathyroidectomy should be reserved for progressive clinical and/or roentgenographic findings.

(Arch Surg 1985;120:578-583)

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