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Saudi Journal of Kidney Diseases and Transplantation
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LETTER TO THE EDITOR Table of Contents   
Year : 2008  |  Volume : 19  |  Issue : 3  |  Page : 454-455
Poor Mineral metabolism as a risk for Early Graft Dysfunction


1 Department of Endocrinology, Medwin Hospitals, Chirag Ali Lane, Nampally, Hyderabad-500 001, India
2 Department of Nephrology, Army Hospital (R&R), New Delhi, India

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How to cite this article:
Hari Kumar K, Kumar A. Poor Mineral metabolism as a risk for Early Graft Dysfunction. Saudi J Kidney Dis Transpl 2008;19:454-5

How to cite this URL:
Hari Kumar K, Kumar A. Poor Mineral metabolism as a risk for Early Graft Dysfunction. Saudi J Kidney Dis Transpl [serial online] 2008 [cited 2019 Nov 18];19:454-5. Available from: http://www.sjkdt.org/text.asp?2008/19/3/454/40512
To The Editor:

We have read the article "Pre-transplant Calcium-Phosphate-Parathormone Homeo­stasis as a Risk Factor for Early Graft Dysfunction" by F. Ahmadi et al. [1] How­ever, we have few queries for which clari­fication is required from the authors:

  1. Increased levels of serum phosphate and parathyroid hormone in patients with de­layed graft function (DGF) may indicate deranged mineral metabolism prior to trans­plantation. Thus, it appears that patients with slow graft function (SGF) and DGF group were not adequately prepared for transplantation which may jeopardize the outcome.
  2. Data regarding the use of phosphate bin­ders, calcimimetics and calcium supple­ments was not available amongst groups to assess the comparability and the reasons behind persisting mineral abnormalities.
  3. The mean age of patients in DGF group was 27.7 yrs with dialysis duration of 244 months (> 20 yrs). Out of 14 patients in the group only 4 had underlying diabetes. The etiology of CKD is unclear in this group as most of the patients appear to have started receiving dialysis at a very young age.
  4. The mean duration of dialysis was sig­nificantly different between the groups. Could this have contributed to worse out­come as DGF is seen with increasing dura­tion of dialysis?[2] It would be appropriate to select matching population to evaluate the risk factors for graft dysfunction in LDKT.
  5. Hyperparathyroidism in Chronic Kidney Disease (CKD) patients is usually secon­dary to hypocalcemia. [3] Hypercalcemia in­duced renal dysfunction is a different sub­set and not seen in CKD patients.


I would like to thank the authors for an interesting paper highlighting the impor­tance of pretransplant mineral metabolism in order to achieve good post transplant out­come in CKD patients.

 
   References Top

1.Ahmadi F, Ali-Madadi A, Lessna-Pezeshki M, et al. Pre-transplant calcium-phosphate­parathormone homeostasis as a risk factor for early graft dysfunction. Saudi J Kidney Dis Transpl 2008;19(1):54-8.  Back to cited text no. 1    
2.Figueiredo A, Moreira P, Parada B, et al. Risk factors for delayed renal graft function and their impact on renal transplantation outcome. Transplant Proc 2007;39(8):2473-5.  Back to cited text no. 2    
3.Hruska KA, Saab G, Mathew S, Lund R. Renal osteodystrophy, phosphate homeo­stasis and vascular calcification. Semin Dial 2007;20(4):309-15.  Back to cited text no. 3    

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Correspondence Address:
KVS Hari Kumar
Department of Endocrinology, Medwin Hospitals, Chirag Ali Lane, Nampally, Hyderabad-500 001
India
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PMID: 18445912

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