Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Doi, Yohei; Hamano, Takayuki; Ichimaru, Naotsugu; Tomida, Kodo; Obi, Yoshitsugu; Fujii, Naohiko; Yamaguchi, Satoshi; Oka, Tatsufumi; Sakaguchi, Yusuke; Matsui, Isao; Kaimori, Jun ya; Abe, Toyofumi; Imamura, Ryoichi; Takahara, Shiro; Tsubakihara, Yoshiharu; Nonomura, Norio; Isaka, Yoshitaka

doi:https://doi.org/10.1038/s41598-020-70709-4

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

Doi, Yohei; Hamano, Takayuki; Ichimaru, Naotsugu et al.

Scientific Reports, 2020, 10(1), 13766

Number of Access:2,444（2025-09-12 08:37 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/92483

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Title	Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients
Creator	NRID 1000030846382 1000030846382 ORCID 0000-0002-5165-291X 0000-0002-5165-291X researchmap permalink DOI-YOHEI DOI-YOHEI CreatorName Doi, Yohei
	CreatorName Hamano, Takayuki
	CreatorName Ichimaru, Naotsugu
	CreatorName Tomida, Kodo
	CreatorName Obi, Yoshitsugu
	CreatorName Fujii, Naohiko
	CreatorName Yamaguchi, Satoshi
	NRID 1000010795173 1000010795173 CreatorName Oka, Tatsufumi
	NRID 1000080756817 1000080756817 researchmap permalink sakaguchi-handai3857 sakaguchi-handai3857 Scopus Author ID 35183980700 35183980700 ORCID 0000-0002-0987-5423 0000-0002-0987-5423 CreatorName Sakaguchi, Yusuke
	NRID 1000060456986 1000060456986 ORCID 0000-0001-8378-6130 0000-0001-8378-6130 researchmap permalink matsui-handai3857 matsui-handai3857 Scopus Author ID 24488796300 24488796300 CreatorName Matsui, Isao
	NRID 1000070527697 1000070527697 CreatorName Kaimori, Jun ya
	Scopus Author ID 8206439800 8206439800 CreatorName Abe, Toyofumi
	Scopus Author ID 7005140192 7005140192 CreatorName Imamura, Ryoichi
	NRID 1000070179547 1000070179547 researchmap permalink read0080308 read0080308 CreatorName Takahara, Shiro
	NRID 1000010638026 1000010638026 CreatorName Tsubakihara, Yoshiharu
	NRID 1000030263263 1000030263263 researchmap permalink read0185096 read0185096 Scopus Author ID 7005880662 7005880662 CreatorName Nonomura, Norio
	NRID 1000000379166 1000000379166 researchmap permalink isaka-handai3857 isaka-handai3857 Scopus Author ID 16207611100 16207611100 ORCID 0000-0002-0820-7167 0000-0002-0820-7167 CreatorName Isaka, Yoshitaka
Description	Doi Y., Hamano T., Ichimaru N., et al. Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients. Scientific Reports 10, 13766 (2020); https://doi.org/10.1038/s41598-020-70709-4.
Abstract	Separate assessment of mineral bone disorder (MBD) parameters including calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D (1,25D) predict renal outcomes in kidney transplant recipients (KTRs), with conflicting results. To date, data simultaneously evaluating these parameters and interwoven relations on renal outcomes are scarce. We conducted a prospective long-term follow-up cohort study included 263 KTRs with grafts functioning at least 1 year after transplantation. The outcome was a composite of estimated GFR halving and graft loss. Cox regression analyses were employed to evaluate associations between a panel of six MBD parameters and renal outcomes. The outcome occurred in 98 KTRs during a median follow-up of 10.7 years. In a multivariate Cox analysis, intact PTH (iPTH), phosphate, and 1,25D levels were associated with the outcome (hazard ratio, 1.60 per log scale; 95% confidence interval, 1.19–2.14, 1.60 per mg/dL; 1.14–2.23 and 0.82 per 10 pg/mL; 0.68–0.99, respectively). Competing risk analysis with death as a competing event yielded a similar result. After stratification into four groups by iPTH and phosphate medians, high risks associated with high iPTH was not observed in KTRs with low phosphate levels (P-interaction < 0.1). Only KTRs not receiving active vitamin D, poor 1,25D status predicted the worse outcome (P-interaction < 0.1). High iPTH, phosphate, and low 1,25D, but not FGF23, levels predicted poor renal outcomes. Simultaneous evaluation of PTH and phosphate levels may provide additional information regarding renal allograft prognosis.
Publisher	Nature Research
Source Title	Scientific Reports
Volume (Issue)	10(1)
Page	13766
Date of Issued	2020-08-13
Language	English
Handle URL	https://hdl.handle.net/11094/92483
eISSN	20452322
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1038/s41598-020-70709-4
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Scientific Reports. 2020, 10(1), p. 13766
DC.title	Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients
DC.creator	Doi, Yohei
	Hamano, Takayuki
	Ichimaru, Naotsugu
	Tomida, Kodo
	Obi, Yoshitsugu
	Fujii, Naohiko
	Yamaguchi, Satoshi
	Oka, Tatsufumi
	Sakaguchi, Yusuke
	Matsui, Isao
	Kaimori, Jun ya
	Abe, Toyofumi
	Imamura, Ryoichi
	Takahara, Shiro
	Tsubakihara, Yoshiharu
	Nonomura, Norio
	Isaka, Yoshitaka
DC.publisher	Nature Research
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2020-08-13
DC.identifier	https://doi.org/10.1038/s41598-020-70709-4
DC.description	Doi Y., Hamano T., Ichimaru N., et al. Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients. Scientific Reports 10, 13766 (2020); https://doi.org/10.1038/s41598-020-70709-4.
DCTERMS.abstract	Separate assessment of mineral bone disorder (MBD) parameters including calcium, phosphate, parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D (1,25D) predict renal outcomes in kidney transplant recipients (KTRs), with conflicting results. To date, data simultaneously evaluating these parameters and interwoven relations on renal outcomes are scarce. We conducted a prospective long-term follow-up cohort study included 263 KTRs with grafts functioning at least 1 year after transplantation. The outcome was a composite of estimated GFR halving and graft loss. Cox regression analyses were employed to evaluate associations between a panel of six MBD parameters and renal outcomes. The outcome occurred in 98 KTRs during a median follow-up of 10.7 years. In a multivariate Cox analysis, intact PTH (iPTH), phosphate, and 1,25D levels were associated with the outcome (hazard ratio, 1.60 per log scale; 95% confidence interval, 1.19–2.14, 1.60 per mg/dL; 1.14–2.23 and 0.82 per 10 pg/mL; 0.68–0.99, respectively). Competing risk analysis with death as a competing event yielded a similar result. After stratification into four groups by iPTH and phosphate medians, high risks associated with high iPTH was not observed in KTRs with low phosphate levels (P-interaction < 0.1). Only KTRs not receiving active vitamin D, poor 1,25D status predicted the worse outcome (P-interaction < 0.1). High iPTH, phosphate, and low 1,25D, but not FGF23, levels predicted poor renal outcomes. Simultaneous evaluation of PTH and phosphate levels may provide additional information regarding renal allograft prognosis.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	92483
citation_title	Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients
citation_author	Doi, Yohei
	Hamano, Takayuki
	Ichimaru, Naotsugu
	Tomida, Kodo
	Obi, Yoshitsugu
	Fujii, Naohiko
	Yamaguchi, Satoshi
	Oka, Tatsufumi
	Sakaguchi, Yusuke
	Matsui, Isao
	Kaimori, Jun ya
	Abe, Toyofumi
	Imamura, Ryoichi
	Takahara, Shiro
	Tsubakihara, Yoshiharu
	Nonomura, Norio
	Isaka, Yoshitaka
citation_publisher	Nature Research
citation_language	English
citation_date	2020-08-13
citation_journal_title	Scientific Reports
citation_volume	10
citation_issue	1
citation_firstpage	13766
citation_doi	https://doi.org/10.1038/s41598-020-70709-4
citation_public_url	https://hdl.handle.net/11094/92483

Serum phosphate levels modify the impact of parathyroid hormone levels on renal outcomes in kidney transplant recipients

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