Calcium and phosphorus metabolism disturbances after renal transplantation.

INTRODUCTION: Several studies have noted that, despite beneficial correction of abnormalities of mineral metabolism after successful renal transplantation, renal functional recovery is incomplete. Also, persistence of hyperparathyroidism and metabolic acidosis among patients with chronic impairment of graft function together with the use of loop diuretics and immunosuppressive drugs with adverse effects may alter mineral metabolism. We determined calcium and phosphorus levels in recipients. METHODS: This cross-sectional study enrolled 398 recipients in 2 medical centers in Iran from 1988 to 2004 to evaluate serum calcium and phosphorus levels after 1 month in relation to graft and patient survivals. Cyclosporine was the constant part of the immunosuppressive treatment in all study subjects. RESULTS: The median follow-up time was 8 months (range, 1-180 months). One and 10-year survival rates of patients were 97.9% and 91.1%. Mean (SD) serum calcium levels before and after transplantation were 8.79 (1.26) and 8.50 (1.39) mg/dL, respectively (P=.020). The mean (SD) phosphate levels before and after transplantation were 6.43 (2.42) and 3.64 (1.71) mg/dL, respectively (P=.000). There was no significant difference in survival considering changes in serum calcium and phosphorus levels. There was no correlation between serum calcium and phosphorus level changes among study patients. CONCLUSIONS: Despite reports suggesting hypercalcemia as a posttransplantation finding, we did not observe this condition, but, consistent with other reports in this field, we observed a significant decrease in serum phosphorus levels showing correction of this mineral level.

Hyperlipidemia after renal transplantation and its relation to graft and patient survival.

INTRODUCTION: Hyperlipidemia is a multifactorial event that frequently develops following renal transplantation and may worsen the patient's prognosis. The aim of this study was to evaluate the incidence and concomitant factors for hyperlipidemia. METHODS: We studied 687 renal transplant recipients from 1988 to 2004 using a cross-sectional design to determine the frequency of hypercholestrolemia and hypertriglyceridemia before and 1 month to 1 year after renal transplantation, to evaluate its relation to patient and graft prognosis in two medical centers in Iran. Cyclosporine was the constant part of immunosuppressive treatment in all study subjects. RESULTS: One and 5-year graft survival times were 94.23% and 81.34%, respectively. The prevalence of hypercholestrolemia after transplantation was 59.9%. Mean (+/- 2 SE) serum cholesterol levels before and after transplantation were 161.15 +/- 3.81 and 213.83 +/- 4.53 mg/dL respectively (P=.000). Triglycerides levels, were 159.99 +/- 13.08 and 196.28 +/- 19.6 mg/dL respectively. There was no significant correlation between cyclosporine dose, graft and patient survivals, and severity of hyperlipidemia (determined by cholesterol and triglyceride levels). CONCLUSIONS: Lipid metabolism abnormalities observed in this study were similar to other reports. There was no correlation with patient or graft survival. In addition, there may routes for development of hyperlipidemia other than adverse complications of immunosuppressive drugs.