Introduction: Tertiary hyperparathyroidism in kidney transplant recipients is a serious condition that can persist even after a successful transplantation.This disorder has been associated with graft dysfunction, cardiovascular complications, osteopenia, and various systemic symptoms.The most appropriate first-line therapy for managing tertiary hyperparathyroidism in kidney transplant recipients is still a topic of debate.Methods: We conducted a retrospective, single-center observational study involving kidney transplant recipients with tertiary hyperparathyroidism from a patient pool between January 2010 and January 2025.Patients were identified using the database at the Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.The kidney transplant recipients were categorized based on their treatment: medical management, parathyroidectomy, or no treatment.We compared serum calcium and phosphorus levels, changes in serum creatinine levels, as well as rates of death-censored and all-cause allograft failure among the treatment groups.Results: An interim analysis was performed on 20 kidney transplant recipients, 8 of whom underwent parathyroidectomy.Recipients with no treatment had shorter dialysis vintage, lower parathyroid hormone levels, and a later onset of hypercalcemia.Parathyroidectomy was associated with a significant reduction in serum calcium levels compared to medical management (p < 0.01).Persistent hypercalcemia was more common in the no treatment group than in the medical management and parathyroidectomy groups (p < 0.01).Treatment with either parathyroidectomy or medical management was linked to a lower risk of both death-censored allograft failure and all-cause allograft failure.Conclusion: Treatment for tertiary hyperparathyroidism is associated with improved graft survival.Parathyroidectomy was found to result in a greater reduction in serum calcium levels and decreased chances of persistent hypercalcemia.I have no potential conflict of interest to disclose.I did not use generative AI and AI-assisted technologies in the writing process.
Pilawan et al. (Wed,) studied this question.