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Rapid onset intratubular calcification following renal transplantation requiring urgent parathyroidectomy

Lookup NU author(s): Dr Avinash Sewpaul, Professor John SayerORCiD, Nigel Jones, David Talbot, Dr Suren Kanagasundaram


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Background: Secondary hyperparathyroidism is a common complication of end-stage renal disease often requiring parathyroidectomy. Renal transplant with the restoration of normal renal function often allows resolution of hyperparathyroidism, avoiding the need for parathyroid surgery. However, a proportion of patients with hyperparathyroidism become overtly hypercalcemic after renal transplantation which poses management dilemmas between medical and surgical treatment. Case: We present the case of a 48-year-old man with end-stage renal failure known to have secondary hyperparathyroidism who received a living related renal transplant. Post-operatively he developed prompt hypercalcemia, polyuria, polydipsia and rapid onset intratubular calcification, leading to acute tubular necrosis diagnosed on renal biopsy on Day 7 post transplantation. He underwent surgical parathyroidectomy with resolution of his hypercalcemia and improved renal transplant function. Discussion: This case emphasizes the need for good management of secondary hyperparathyroidism together with close surveillance of PTH in patients awaiting renal transplantation. With good renal transplant function hyperparathyroidism usually resolves. Posttransplant surgical parathyroidectomy should be reserved for severe progressive end organ damage. © 2007 Dustri-Verlag Dr. K. Feistle.

Publication metadata

Author(s): Sewpaul A, Sayer JA, Mohamed MAS, Ahmed A, Shaw M, Prabhu VR, Wood K, Jones NA, Talbot D, Kanagasundaram NS

Publication type: Article

Publication status: Published

Journal: Clinical Nephrology

Year: 2007

Volume: 68

Issue: 1

Pages: 47-51

Print publication date: 01/07/2007

ISSN (print): 0301-0430

ISSN (electronic):

Publisher: Dustri-Verlag Dr. Karl Feistle