BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
目的采用文献计量学方法和可视化工具评估近20年甲状旁腺超声研究的内容、趋势及新兴热点,期望分析结果对未来的研究能提供参考。方法在PubMed和Web of Science Core Collection(WOSCC)数据库中进行了全面检索,筛选了2004年1月1日~2024...目的采用文献计量学方法和可视化工具评估近20年甲状旁腺超声研究的内容、趋势及新兴热点,期望分析结果对未来的研究能提供参考。方法在PubMed和Web of Science Core Collection(WOSCC)数据库中进行了全面检索,筛选了2004年1月1日~2024年9月5日间发表的甲状旁腺超声相关研究,共纳入1609篇文章。采用CiteSpace和VOSviewer进行文献计量学分析,识别甲状旁腺超声研究的出版趋势、关键贡献者和研究热点等。结果术前定位、先进影像技术及热消融等创新治疗方法是甲状旁腺超声研究的重点领域。中国和美国在研究产出方面处于领先地位。发文量最多的作者来自中国,World Journal of Surgery是该领域发文量最多的期刊。近期的热点关键词包括继发性甲状旁腺功能亢进症、甲状旁腺切除术和热消融术。未来的研究预计将强调跨学科合作以及新兴影像技术的整合。结论本研究为近20年甲状旁腺超声研究提供了全面的概述,显示了未来新的发展趋势。展开更多
文摘BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
文摘目的采用文献计量学方法和可视化工具评估近20年甲状旁腺超声研究的内容、趋势及新兴热点,期望分析结果对未来的研究能提供参考。方法在PubMed和Web of Science Core Collection(WOSCC)数据库中进行了全面检索,筛选了2004年1月1日~2024年9月5日间发表的甲状旁腺超声相关研究,共纳入1609篇文章。采用CiteSpace和VOSviewer进行文献计量学分析,识别甲状旁腺超声研究的出版趋势、关键贡献者和研究热点等。结果术前定位、先进影像技术及热消融等创新治疗方法是甲状旁腺超声研究的重点领域。中国和美国在研究产出方面处于领先地位。发文量最多的作者来自中国,World Journal of Surgery是该领域发文量最多的期刊。近期的热点关键词包括继发性甲状旁腺功能亢进症、甲状旁腺切除术和热消融术。未来的研究预计将强调跨学科合作以及新兴影像技术的整合。结论本研究为近20年甲状旁腺超声研究提供了全面的概述,显示了未来新的发展趋势。
