Clinical factors associated with severe hypophosphataemia after kidney transplant

Ralston, M. R., Stevenson, K. S., Mark, P. B. and Geddes, C. C. (2021) Clinical factors associated with severe hypophosphataemia after kidney transplant. BMC Nephrology, 22, 407. (doi: 10.1186/s12882-021-02624-3)

Abstract

Background: The mechanism by which hypophosphataemia develops following kidney transplantation remains debated, and limited research is available regarding risk factors. This study aimed to assess the association between recipient and donor variables, and the severity of post-transplantation hypophosphataemia. Methods: We performed a single-centre retrospective observational study. We assessed the association between demographic, clinical and biochemical variables and the development of hypophosphataemia. We used linear regression analysis to assess association between these variables and phosphate nadir. Results: 87.6% of patients developed hypophosphataemia. Patients developing hypophosphataemia were younger, had a shorter time on renal replacement therapy, were less likely to have had a parathyroidectomy or to experience delayed graft function, were more likely to have received a living donor transplant, from a younger donor. They had higher pre-transplantation calcium levels, and lower alkaline phosphatase levels. Receipt of a living donor transplant, lower donor age, not having had a parathyroidectomy, receiving a transplant during the era of tacrolimus-based immunosuppression, not having delayed graft function, higher pre-transplantation calcium, and higher pre-transplantation phosphate were associated with lower phosphate nadir by multiple linear regression. Conclusions: This analysis demonstrates an association between variables relating to better graft function and hypophosphataemia. The links with biochemical measures of mineral-bone disease remain less clear.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ralston, Dr Maximilian and Mark, Professor Patrick and Stevenson, Dr Karen and Geddes, Dr Colin
• Authors: Ralston, M. R., Stevenson, K. S., Mark, P. B., and Geddes, C. C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: BMC Nephrology
• Publisher: BioMed Central
• ISSN: 1471-2369
• ISSN (Online): 1471-2369
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in BMC Nephrology 22: 407
• Publisher Policy: Reproduced under a Creative Commons License