Phosphate Level Post Kidney Transplantation

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Muzdejer Khudhair Abbas, Ali Jassim Hashim AL Saedi


BackgroundKidney transplant relief many of the disorders accompanying end stage renal disease (ESRD). However, hypophosphatemia is common complication after kidney transplantation. High level of fibroblast growth factor 23 (FGF-23) and parathyroid hormone (PTH) are two suspected elements determining the hypophosphatemia after kidney transplantation.

ObjectivesWe search at hypothesis that factors contributes to hypophosphatemia, independently of parathyroid hormone(PTH) and maintaining phosphate metabolism in early post transplantation.

Patients and methods Eligible patients were aged 30-60 with no systemic illness such as decompensated liver or respiratory disease,  active malignancy. 60 patients divided into 3 groups according to period of transplantation. Group A 15 patients with 6 months duration of transplant. Group B 15 patients with 1 year duration of  transplant .Group C 30 patients with 2 years duration of transplant.Calcidiol, PTH, corrected calcium. albumin, phosphorus were collected from all patients.

Reference levels of 2.5-4.5 and 8.5-10.3 mg\dl were used for serum phosphorus and calcium levels respectively. PTH level 10-65 pg/ml. Serum urea and creatinine were collected and exclude those with impaired renal function.

Results: 33.3% in group A(six months)  are between 30 -39, 66.6 % in group B(1 year post transplant) are between 30-49, while 33.3% in group C(2 years post transplant)are between 40-49. Male percentage 66.7%,60%,70% in group A(six months post transplant), group B(1 year) and group C (2 years) respectively.

 The mean of serum calcium 9.55+-0.52,9.84+-0.53, 9.46+-0.49 in the three groups respectively. Serum phosphate 2.97+-0.8, 2.79+-0.56, 3.50+-0.61 in the three groups respectively. PTH  75+-11.15, 68.9, 49.97+-6.08 , in the three groups respectively .

ConclusionIn conclusion our data indicate elements other than PTH like (FGF23) is highly associated with hypophosphatemia, independently of PTH.Hypophosphatemia is more commen during early stage of transplantation(1 year post transplant).

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