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| Year : 2008 | Volume
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| Issue : 3 | Page : 454-455 |
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| Poor Mineral metabolism as a risk for Early Graft Dysfunction |
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KVS Hari Kumar1, Arun Kumar2
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
Click here for correspondence address and email
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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 2020 Dec 5];19:454-5. Available from: https://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:
- 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.
- 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.
- 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.
- 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.
- 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 | |  |
| 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.  |
| 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. |
| 3. | Hruska KA, Saab G, Mathew S, Lund R. Renal osteodystrophy, phosphate homeostasis and vascular calcification. Semin Dial 2007;20(4):309-15. |
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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