الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Although kidney transplant recipients profit from improved allograft survival, they have to live with the consequences of their chronic kidney disease for the rest of their lives. Secondary hyperparathyroidism is one of the side effects of CKD that can be hard to deal with after a kidney transplant. Aim : This work aims to compare the short and long-term impact of parathyroidectomy vs. cinacalcet on renal allograft survival and CKD-MBD profile. Methods : This retrospective study reviewed the medical records of 334 kidney transplant recipients at Sheffield Teaching Hospitals, UK. It included patients who underwent a kidney transplant between January 2007 and December 2014. We identified three groups : group I (parathyroidectomy group) and group II (cinacalcet group) and the third group (control group), which includes patients who were transplanted in the same period, but did not undergo parathyroidectomy or receive cinacalcet before transplantation. These patients underwent regular follow-up after kidney transplantation, and we analyzed the results of tests related to mineral bone diseases, such as parathyroid hormone, calcium, phosphorus, and vitamin D levels. Results : The results have shown that all groups had a comparable patient and graft survival. Also, the eGFR showed no statistically significant difference among the groups. The baseline bone profile chemistry showed that the parathyroidectomy group had the lowest levels of iPTH and alkaline phosphatase among the study groups. In addition, the parathyroidectomy group had the lowest levels of iPTH at 1-year follow-up and last year’s follow-up. However, the clinical significance of these findings is still uncertain. This study confirms that there is a link between the treatment method of pre-transplant hyperparathyroidism and the development of post-transplant persistent hyperparathyroidism, as the parathyroidectomy patients had significantly lower odds of THPT than the cinacalcet patients. Conclusions : Based on these findings, parathyroidectomy – as a treatment for pre-transplant hyperparathyroidism – is effective and safe in HD patients preparing for kidney transplantation, with the opportunity to reduce the incidence of post-transplant hyperparathyroidism. However, its superiority to cinacalcet treatment could not be proven.