Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function.

Background: The aim of the study was to investigate whether serum levels of intact parathyroid hormone (iPTH) are associated with an increased risk of cardiovascular events, graft loss, or mortality in kidney transplant patients with optimal transplant function.

Methods: From the Norwegian Renal Registry, we identified 522 patients who received a first kidney transplant from 2001 to 2008 with optimal transplant function defined as an estimated glomerular filtration rate (eGFR)≥60 mL/min/1.73 m2, more than one yr after transplantation.

Soluble Klotho and intact fibroblast growth factor 23 in long-term kidney transplant patients.

Background: Controversies exist whether disturbances in mineral and bone disorder (MBD) normalise or persist after kidney transplantation. We assessed markers of MBD in patients with well-functioning kidney transplants to minimise confounding by reduced transplant function.

Methods: In this cross-sectional study, 40 patients aged ≥18 years who received a first kidney transplant more than 10 years ago were included.

Health-related quality of life in kidney transplant patients and non-renal replacement therapy patients with chronic kidney disease stages 3b-4.

Background: Patients with a functioning kidney transplant (Tx) and patients with chronic kidney disease (CKD) not in dialysis report better health-related quality of life (HRQoL) than patients requiring dialysis, but poorer than the general population. HRQoL is associated with kidney function, but it is unknown whether the kidney function per se is the main determinant of HRQoL. The aim of this study was to compare the HRQoL in 2 groups of patients with CKD: 1 group with native kidneys only (non-renal replacement therapy [non-RRT] group) and 1 group with a functioning kidney transplant (Tx group).

Fibroblast growth factor 23 and parathyroid hormone after treatment with active vitamin D and sevelamer carbonate in patients with chronic kidney disease stage 3b, a randomized crossover trial.

Background: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that is secreted from bone and serum level increases as renal function declines. Higher levels of FGF23 are associated with increased mortality in hemodialysis-patients and in patients with chronic kidney disease (CKD) stage 2-4. The use of active vitamin D and phosphate binders as recommended in international guidelines, may affect the level of FGF23 and thereby clinical outcome.

Prevalence of diabetic retinopathy in Norway: report from a screening study.

Purpose: The purpose of the present study was to investigate the prevalence of diabetic retinopathy (DR) in Norway and adherence to the Norwegian Guidelines for screening for diabetic eye disease.

Methods: Two hundred and ninety-nine people with diabetes were randomly recruited from the patient lists of randomly selected general practitioners from three different regions in Norway. Retinopathy was evaluated from retinal photographs after dilation of the pupils using a red-free digital camera and visual acuity was measured using the Snellen chart.

Intact parathyroid hormone levels in renal transplant patients with normal transplant function.

Introduction: Chronic kidney disease mineral and bone disorder (CKD-MBD) is common in patients who have undergone kidney transplantation. There is limited information on the extent to which patients with normal renal function after transplantation have persistent disturbances in their mineral metabolism.

Aim: The aim of the study is to investigate the prevalence of elevated intact parathyroid hormone (iPTH) levels at least one yr after transplantation in patients living with a first renal transplant with normal transplant function.

Undiagnosed diabetes in kidney transplant candidates: a case-finding strategy.

Background And Objectives: Guidelines recommend that candidates for kidney transplantation (KTx) who do not have diabetes perform a pretransplantation oral glucose tolerance test (OGTT) when fasting plasma glucose (FPG) is <110 mg/dl (<6.1 mmol/L); however, the OGTT is potentially costly and cumbersome. We studied the role of the OGTT for diagnosing diabetes and the accuracy of FPG and glycated hemoglobin (HbA(1c)) for predicting a diabetic OGTT before KTx.

Glucose tolerance before and after renal transplantation.

Background: Renal insufficiency predisposes to insulin resistance, hyperparathyroidism and derangements in calcium phosphate and nitrogenous compound balance, leading to pre-transplant hyperglycaemia. These metabolic risk factors are not fully corrected after renal transplantation. The present study aimed to assess the role of pre-transplant glycaemia and the named metabolic risk factors in post-transplant hyperglycaemia [PHYG; impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or diabetes mellitus (DM)].

The Nephrocare project: referral, patient case-mix, follow-up and quality of renal care in Nordic renal centres.

Objective: Few studies have focused on patients actually attending renal units for their follow-up over time. This study reports the type of prevalent patients (case-mix) with a renal condition being followed up by 19 renal units in the Nordic countries during 1998-99.

Material And Methods: In a joint quality of care development project between the renal societies of the five Nordic countries and the unit for Quality of Health Systems, WHO (Europe), 19 renal units collected data on a random sample of their prevalent patients.

Role of prednisolone pharmacokinetics in postchallenge glycemia after renal transplantation.

Prednisolone may cause hyperglycemia after organ transplantation. Even at comparable weight-adjusted doses, prednisolone side effects vary considerably between individuals, suggesting between-patient pharmacokinetic differences. In renal transplant patients, assessment of glucocorticoid diabetogenicity is confounded by calcineurin inhibitors (CNIs).

Renal transplant and secondary hyperparathyroidism.

Objective: To investigate the impact of mineral metabolism, renal function, months on dialysis and months since transplant for predicting intact parathyroid hormone (iPTH) levels in a cohort of patients who had undergone their first renal graft with estimated glomerular filtration rates (eGFRs) of 30-60 and >60 ml/min/1.73 m2.

Material And Methods: One hundred and twenty-eight patients (mean age 56.

Albumin-corrected or ionized calcium in renal failure? What to measure?

Background: Secondary hyperparathyroidsm is frequently observed in patients with chronic renal failure, and clinical treatment guidelines have been published. Despite this, a large proportion of patients do not reach the target levels for calcium, phosphorus, calcium x phosphorus product, or intact parathyroid hormone. The use of albumin-corrected calcium is recommended as calcium measurement, but it is the concentration of ionized calcium that is biologically active.

C2 monitoring in maintenance renal transplant recipients: is it worthwhile?

Presently, there is little knowledge regarding cyclosporine (CsA) concentration at 2 hr post-dose (C2) monitoring in maintenance patients. This study evaluates the actual C2 range in stable renal transplant recipients (who underwent transplantation >12 months ago). In addition, we investigated whether underexposure or overexposure to CsA (assessed by C2) affects graft function (as measured by serum [S]-creatinine).