Secondary hyperparathyroidism is a risk factor associated with graft survival in pediatric patients with renal transplantation: a single-center study Original Research

Abstract

Introduction: Kidney transplantation in pediatrics is the treatment of choice for end-stage renal disease (ESRD) and has widely proven advantages over dialysis treatments. The aim of the present study was to determine the risk factors related to global and graft survival in a group of pediatric kidney transplant patients treated at a national referral hospital with observation of factors associated with secondary hyperparathyroidism.

Methods: The present observational, retrospective study was carried out in the Hospital Metropolitano de Quito, Ecuador, from January 1, 2010, to June 30, 2013. We studied mortality and graft survival, presence of hyperparathyroidism before transplantation, and demographic and clinical variables (compatibility). The Kaplan Meier method was used for analysis, and relative risks are presented.

Results: 33 patients aged 12 ± 3.8 years entered the study. There were cadaveric donors in 21 cases (63.6%) and living donors in 12 patients (36.4%). 18 were men (54.5%). The etiology of ESRD was indeterminate in 63.6%, nephropathies in 24.2%, and uropathies in 12.1%. there was cute rejection in 1 patient and late rejection in 10 patients. Variables with significance in graft survival were hyperparathyroidism (RR = 6.0 (95% CI = 1.078-45.902) P = 0.032), not receiving complete immunosuppression (RR = 14.5 (95% CI = 3.807-55.225) P <0.001), and the need for post-transplant dialysis in the first week and early biopsy (RR = 15 (95% CI = 3.9-57.2)).

Conclusions: This study demonstrated that secondary hyperparathyroidism is a negative risk factor for kidney graft survival in pediatric transplant patients.