nidНефрология и диализNephrology and Dialysis1680-44222618-9801Российское диализное общество10.28996/2618-9801-2020-4-496-505nid-236Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОстрое почечное повреждение после паратиреоидэктомии по поводу первичного гиперпаратиреоза: распространённость и факторы рискаAcute kidney injury after parathyroidectomy for primary hyperparathyroidism: prevalence and risk factorsПаршинаЕ. В.ParshinaE. V.pannn@yandex.ruЗулькарнаевА. Б.ZulkarnaevA. B.noemail@neicon.ruМихайловаС. С.MikhaylovaS. S.noemail@neicon.ruКислыйП. Н.KislyyP. N.noemail@neicon.ruЧерниковР. А.ChernikovR. A.noemail@neicon.ruСанкт-Петербургский государственный университетРоссияSaint Petersburg State University HospitalRussian FederationГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияM.F. Vladimirsky Moscow Regional Research Clinical InstituteRussian Federation202030072024224496505Copyright © Паршина Е.В., Зулькарнаев А.Б., Михайлова С.С., Кислый П.Н., Черников Р.А., 20242024Паршина Е.В., Зулькарнаев А.Б., Михайлова С.С., Кислый П.Н., Черников Р.А.Parshina E.V., Zulkarnaev A.B., Mikhaylova S.S., Kislyy P.N., Chernikov R.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephro.ru/jour/article/view/236

Цель: оценить распространённость острого почечного повреждения (ОПП) среди пациентов, оперированных по поводу первичного гиперпаратиреоза (ПГПТ), проанализировать возможные факторы риска развития послеоперационного ОПП. Материалы и методы. В ретроспективное когортное исследование включено 290 пациентов, которым была выполнена успешная селективная паратиреоидэктомия (ПТЭ) по поводу ПГПТ. Мы не включали в анализ пациентов, которым ПТЭ проводилась повторно. Диагноз ОПП устанавливался в соответствии с рекомендациями KDIGO-2012. Результаты. Частота развития ОПП составила 36,6% (106 из 290 пациентов). С риском развития ОПП были ассоциированы высокие значения ПТГ до операции: медиана исходной концентрации ПТГ у пациентов с ОПП составила 17,75 пмоль/л [Q1-Q3: 12; 24,2] против 13,8 пмоль/л [Q1-Q3: 10,2; 19,6] у пациентов без ОПП, p=0,0004. Высокие значения разности ПТГ до/после операции также были связаны с риском развития ОПП: медиана ΔПТГ у пациентов с ОПП составила 16,7 пмоль/л [Q1-Q3: 10; 23] против 11,35 пмоль/л [Q1-Q3: 7,4; 17] у пациентов без ОПП, p<0,0001. У пациентов с ОПП медиана максимального размера аденомы околощитовидной железы была больше: 20 мм [Q1-Q3: 10; 25] против 15 мм [Q1-Q3: 10; 20] у пациентов без ОПП, p=0,0184. Риск ОПП также был связан с высоким уровнем общего кальция до операции: 2,83±0,29 ммоль/л в группе пациентов с ОПП против 2,71±0,22 ммоль/л в группе пациентов без ОПП, p=0,0158. Риск ОПП был существенно выше у пациентов с протеинурией: RR=1,9 [95%ДИ 1,19; 3,54], OR=3,67 [95%ДИ 1,5; 8,73], p=0,0061. При этом на риск послеоперационного ухудшения функции почек не влияли ни предсуществующая хроническая болезнь почек (RR=1,37 [95%ДИ 0,93; 1,9], OR=1,7 [95%ДИ 0,9; 3,2], p=0,1073), ни исходная скорость клубочковой фильтрации (медианы в группах пациентов с ОПП и без ОПП составили 84,45 мл/мин/1,73 м2 [Q1-Q3: 65,5; 96,6] и 76,6 мл/мин/1,73 м2 [Q1-Q3: 64,9; 90,6] соответственно, р=0,118). Пациенты старше 60 лет имели более высокий риск развития ОПП: RR=1,32 [95%ДИ 1,03; 1,72], OR=1,72 [95%ДИ 1,07; 2,83], p=0,0265. Не было выявлено связи ОПП с периоперационным применением небольших доз рентгенконтрастных препаратов (p=0,245) и интраоперационной гипотонией (p=0,79). Выводы. Была выявлена высокая частота развития послеоперационного ОПП после ПТЭ по поводу ПГПТ. Разделение больных на группы в соответствии со степенью риска развития ОПП целесообразно для раннего распознавания и лечения данного осложнения. Для пациентов с риском развития ОПП необходим тщательный мониторинг функции почек в послеоперационном периоде.

Aim. To assess the prevalence of acute renal injury (AKI) among patients who underwent surgery for primary hyperparathyroidism (PHPT), to analyze the possible risk factors for the development of postoperative AKI. Materials and methods. A retrospective cohort study included 290 patients who underwent successful selective parathyroidectomy (PTx) for PHPT. We did not include patients who underwent re-operative surgeries. AKI was defined according to KDIGO-2012 criteria. Results. 106 of 290 patients (36.6%) met AKI criteria after PTx. High preoperative PTH values were associated with AKI risk (median 17,75 pmol/L [Q1-Q3: 12; 24.2] in AKI group vs 13.8 pmol/L [Q1-Q3: 10,2; 19.6] in non-AKI group, p=0.0004). High ΔPTH before/after surgery was also associated with AKI risk (median 16.7 pmol/L [Q1-Q3: 10; 23] in AKI group vs 11.35 pmol/L [Q1-Q3: 7.4; 17] in non-AKI group, p<0.0001). In patients who developed AKI maximum size of the parathyroid adenoma was significantly greater: 20 mm [Q1-Q3: 10; 25] vs 15 mm [Q1-Q3: 10; 20] in non-AKI patients, p=0.0184. AKI risk was also associated with high preoperative serum calcium level: 2.83±0.29 mmol/L in AKI group vs 2.71±0.22 mmol/L in non-AKI group, p=0.0158. AKI risk was significantly higher in those with proteinuria: RR=1.9 [95%CI 1.19; 3.54], OR=3.67 [95%CI 1,5; 8.73], р=0.0061. Notable, neither preexisting chronic kidney disease (RR=1,37 [95%CI 0.93; 1.9], OR=1,7 [95%CI 0.9; 3.2], p=0.1073) nor baseline estimate glomerular filtration rate (84.45 ml/min/1.73 m2 [Q1-Q3: 65.5; 96.6] and 76.6 ml/min/1.73 m2 [Q1-Q3: 64.9; 90.6] for AKI and non-AKI patients respectively, р=0.118) were not associated with the risk of postoperative kidney function impairment. Patients of age 60 years and older had greater risk of AKI: RR=1.32 [95%CI 1.03; 1.72], OR=1.72 [95%CI 1.07; 2.83], p=0.0265. There was no association of AKI with perioperative use of contrast media in small doses (р=0.245), or intraoperative hypotension (p=0,79). Conclusions. We observed a high prevalence of AKI in patients after parathyroidectomy for primary HPT. Preoperative risk stratification may help early recognition and treatment of renal function impairment. For those at risk of AKI, careful monitoring of renal function is necessary during the postoperative period.

острое почечное повреждениепервичный гиперпаратиреозпаратиреоидэктомияпаратиреоидный гормонкальцийacute kidney injuryprimary hyperparathyroidismparathyroidectomyparathyroid hormonecalciumReferencesДедов И.И., Мельниченко Г.А., Мокрышева Н.Г. и др. Первичный гиперпаратиреоз: клиника, диагностика, дифференциальная диагностика, методы лечения. Проблемы эндокринологии. 2016;62(6):40-47Дедов И.И., Мельниченко Г.А., Мокрышева Н.Г. и др. Первичный гиперпаратиреоз: клиника, диагностика, дифференциальная диагностика, методы лечения. Проблемы эндокринологии. 2016;62(6):40-47Bilezikian J., Brandi M., Eastell R. et al. Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop. The Journal of Clinical Endocrinology & Metabolism. 2014;99(10):3561-3569. doi:10.1210/jc.2014-1413Bilezikian J., Brandi M., Eastell R. et al. Guidelines for the Management of Asymptomatic Primary Hyperparathyroidism: Summary Statement from the Fourth International Workshop. The Journal of Clinical Endocrinology & Metabolism. 2014;99(10):3561-3569. doi:10.1210/jc.2014-1413Miller M., Paradis C., Houck P. et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res 1992; 41:237-48.Miller M., Paradis C., Houck P. et al. Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale. Psychiatry Res 1992; 41:237-48.KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International Supplement 2013;3:1-150KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney International Supplement 2013;3:1-150KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International supplements 2012; 2:1KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International supplements 2012; 2:1Wang Y., Bellomo R. Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nature Reviews Nephrology. 2017;13(11):697-711. doi:10.1038/nrneph.2017.119Wang Y., Bellomo R. Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nature Reviews Nephrology. 2017;13(11):697-711. doi:10.1038/nrneph.2017.119O’Connor M., Kirwan C., Pearse R. et al. Incidence and associations of acute kidney injury after major abdominal surgery. Intensive Care Med. 2015;42(4):521-530. doi:10.1007/s00134-015-4157-7O’Connor M., Kirwan C., Pearse R. et al. Incidence and associations of acute kidney injury after major abdominal surgery. Intensive Care Med. 2015;42(4):521-530. doi:10.1007/s00134-015-4157-7Yu N., Donnan P., Murphy M. et al. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol (Oxf). 2009;71(4):485-493. doi:10.1111/j.1365-2265.2008.03520.xYu N., Donnan P., Murphy M. et al. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol (Oxf). 2009;71(4):485-493. doi:10.1111/j.1365-2265.2008.03520.xKhan A., Hanley D., Rizzoli R. et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporosis International. 2016;28(1):1-19. doi:10.1007/s00198-016-3716-2Khan A., Hanley D., Rizzoli R. et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporosis International. 2016;28(1):1-19. doi:10.1007/s00198-016-3716-2Wilhelm S., Wang T., Ruan D. et al. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg. 2016;151(10):959. doi:10.1001/jamasurg.2016.2310Wilhelm S., Wang T., Ruan D. et al. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg. 2016;151(10):959. doi:10.1001/jamasurg.2016.2310Hyperparathyroidism (primary): diagnosis, assessment and initial management. Nice.org.uk. Published May 2019. Accessed February 3, 2020. https://www.nice.org.uk/guidance/ng132/evidence/i-monitoring-pdf-244177580628; 10.1210/jc.2014-1413Hyperparathyroidism (primary): diagnosis, assessment and initial management. Nice.org.uk. Published May 2019. Accessed February 3, 2020. https://www.nice.org.uk/guidance/ng132/evidence/i-monitoring-pdf-244177580628; 10.1210/jc.2014-1413Egan R., Dewi F., Arkell R. et al. Does elective parathyroidectomy for primary hyperparathyroidism affect renal function? A prospective cohort study. International Journal of Surgery. 2016;27:138-141. doi:10.1016/j.ijsu.2016.01.072Egan R., Dewi F., Arkell R. et al. Does elective parathyroidectomy for primary hyperparathyroidism affect renal function? A prospective cohort study. International Journal of Surgery. 2016;27:138-141. doi:10.1016/j.ijsu.2016.01.072Chagnac A. The effects of weight loss on renal function in patients with severe obesity. Journal of the American Society of Nephrology. 2003;14(6):1480-1486. doi:10.1097/01.asn.0000068462.38661.89Chagnac A. The effects of weight loss on renal function in patients with severe obesity. Journal of the American Society of Nephrology. 2003;14(6):1480-1486. doi:10.1097/01.asn.0000068462.38661.89Safadi S., Hommos M., Enders F. et al. Risk factors for acute kidney injury in hospitalized non-critically ill patients: a population-based study. Mayo Clin Proc. 2020;95(3):459-467. doi:10.1016/j.mayocp.2019.06.011Safadi S., Hommos M., Enders F. et al. Risk factors for acute kidney injury in hospitalized non-critically ill patients: a population-based study. Mayo Clin Proc. 2020;95(3):459-467. doi:10.1016/j.mayocp.2019.06.011Danziger J., Chen K., Lee J. et al. Obesity, acute kidney injury, and mortality in critical illness. Crit Care Med. 2016;44(2):328-334. doi:10.1097/ccm.0000000000001398Danziger J., Chen K., Lee J. et al. Obesity, acute kidney injury, and mortality in critical illness. Crit Care Med. 2016;44(2):328-334. doi:10.1097/ccm.0000000000001398Kheterpal S., Tremper K., Hesung M. et al. Development and validation of an acute kidney injury risk index for patients undergoing general surgery. Anesthesiology. 2009;110(3):505-515. doi:10.1097/aln.0b013e3181979440Kheterpal S., Tremper K., Hesung M. et al. Development and validation of an acute kidney injury risk index for patients undergoing general surgery. Anesthesiology. 2009;110(3):505-515. doi:10.1097/aln.0b013e3181979440Hobson C., Ruchi R., Bihorac A. Perioperative acute kidney injury. Crit Care Clin. 2017;33(2):379-396. doi:10.1016/j.ccc.2016.12.008Hobson C., Ruchi R., Bihorac A. Perioperative acute kidney injury. Crit Care Clin. 2017;33(2):379-396. doi:10.1016/j.ccc.2016.12.008James M., Grams M., Woodward M. et al. A meta-analysis of the association of estimated gfr, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. American Journal of Kidney Diseases. 2015;66(4):602-612. doi:10.1053/j.ajkd.2015.02.338James M., Grams M., Woodward M. et al. A meta-analysis of the association of estimated gfr, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. American Journal of Kidney Diseases. 2015;66(4):602-612. doi:10.1053/j.ajkd.2015.02.338Coca S., Garg A., Swaminathan M. et al. Preoperative angiotensin-converting enzyme inhibitors and angiotensin receptor blocker use and acute kidney injury in patients undergoing cardiac surgery. Nephrology Dialysis Transplantation. 2013;28(11):2787-2799. doi:10.1093/ndt/gft405Coca S., Garg A., Swaminathan M. et al. Preoperative angiotensin-converting enzyme inhibitors and angiotensin receptor blocker use and acute kidney injury in patients undergoing cardiac surgery. Nephrology Dialysis Transplantation. 2013;28(11):2787-2799. doi:10.1093/ndt/gft405Xu N., Long Q., He T. et al. Association between preoperative renin-angiotensin system inhibitor use and postoperative acute kidney injury risk in patients with hypertension. Clin Nephrol. 2018;89(6):403-414. doi:10.5414/cn109319Xu N., Long Q., He T. et al. Association between preoperative renin-angiotensin system inhibitor use and postoperative acute kidney injury risk in patients with hypertension. Clin Nephrol. 2018;89(6):403-414. doi:10.5414/cn109319Gilstrap L., Fonarow G., Desai A. et al. Initiation, continuation, or withdrawal of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and outcomes in patients hospitalized with heart failure with reduced ejection fraction. J Am Heart Assoc. 2017;6(2). doi:10.1161/jaha.116.004675Gilstrap L., Fonarow G., Desai A. et al. Initiation, continuation, or withdrawal of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and outcomes in patients hospitalized with heart failure with reduced ejection fraction. J Am Heart Assoc. 2017;6(2). doi:10.1161/jaha.116.004675McCullough P. Radiocontrast-induced acute kidney injury. Nephron Physiology. 2008;109(4):p61-p72. doi:10.1159/000142938McCullough P. Radiocontrast-induced acute kidney injury. Nephron Physiology. 2008;109(4):p61-p72. doi:10.1159/000142938James M., Grams M., Woodward M. et al. A Meta-analysis of the association of estimated GFR, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. American Journal of Kidney Diseases. 2015;66(4):602-612. doi:10.1053/j.ajkd.2015.02.338James M., Grams M., Woodward M. et al. A Meta-analysis of the association of estimated GFR, albuminuria, diabetes mellitus, and hypertension with acute kidney injury. American Journal of Kidney Diseases. 2015;66(4):602-612. doi:10.1053/j.ajkd.2015.02.338Medel-Herrero A., Mitchell D., Moyce S. et al. The expanding burden of acute kidney injury in Сalifornia: impact of the epidemic of diabetes on kidney injury hospital admissions. Nephrol Nurs J. 2019;46(6):629-640.Medel-Herrero A., Mitchell D., Moyce S. et al. The expanding burden of acute kidney injury in Сalifornia: impact of the epidemic of diabetes on kidney injury hospital admissions. Nephrol Nurs J. 2019;46(6):629-640.Chao C., Wang J., Wu H. et al. Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study. Geroscience. 2018;40(2):201-217. doi:10.1007/s11357-018-0013-3Chao C., Wang J., Wu H. et al. Age modifies the risk factor profiles for acute kidney injury among recently diagnosed type 2 diabetic patients: a population-based study. Geroscience. 2018;40(2):201-217. doi:10.1007/s11357-018-0013-3Gameiro J., Lopes J. Complete blood count in acute kidney injury prediction: a narrative review. Ann Intensive Care. 2019;9(1). doi:10.1186/s13613-019-0561-4Gameiro J., Lopes J. Complete blood count in acute kidney injury prediction: a narrative review. Ann Intensive Care. 2019;9(1). doi:10.1186/s13613-019-0561-4Karkouti K., Grocott H., Hall R. et al. Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2014;62(4):377-384. doi:10.1007/s12630-014-0302-yKarkouti K., Grocott H., Hall R. et al. Interrelationship of preoperative anemia, intraoperative anemia, and red blood cell transfusion as potentially modifiable risk factors for acute kidney injury in cardiac surgery: a historical multicentre cohort study. Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 2014;62(4):377-384. doi:10.1007/s12630-014-0302-yChao C., Wu V., Lai C. et al. Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury. Kidney Int. 2012;82(8):920-927. doi:10.1038/ki.2012.237Chao C., Wu V., Lai C. et al. Advanced age affects the outcome-predictive power of RIFLE classification in geriatric patients with acute kidney injury. Kidney Int. 2012;82(8):920-927. doi:10.1038/ki.2012.237Annual Report USRDS (2017) Chapter 5: acute kidney injury. Am J Kidney Dis. 69 (3 Suppl 1):S107-S132Annual Report USRDS (2017) Chapter 5: acute kidney injury. Am J Kidney Dis. 69 (3 Suppl 1):S107-S132Rewa O., Bagshaw S. Acute kidney injury-epidemiology, outcomes and economics. Nature Reviews Nephrology. 2014;10(4):193-207. doi:10.1038/nrneph.2013.282Rewa O., Bagshaw S. Acute kidney injury-epidemiology, outcomes and economics. Nature Reviews Nephrology. 2014;10(4):193-207. doi:10.1038/nrneph.2013.282Chao C., Tsai H., Wu C. et al. Cross-sectional study of the association between functional status and acute kidney injury in geriatric patients. BMC Nephrol. 2015;16(1). doi:10.1186/s12882-015-0181-7Chao C., Tsai H., Wu C. et al. Cross-sectional study of the association between functional status and acute kidney injury in geriatric patients. BMC Nephrol. 2015;16(1). doi:10.1186/s12882-015-0181-7Chao C., Tsai H., Wu C. et al. Cumulative cardiovascular polypharmacy is associated with the risk of acute kidney injury in elderly patients. Medicine (Baltimore). 2015;94(31):e1251. doi:10.1097/md.0000000000001251Chao C., Tsai H., Wu C. et al. Cumulative cardiovascular polypharmacy is associated with the risk of acute kidney injury in elderly patients. Medicine (Baltimore). 2015;94(31):e1251. doi:10.1097/md.0000000000001251Ronco C., Bellomo R., Kellum J. et al. Critical Care Nephrology, Third Edition. USA: Elsevier; 2018: 54-59.Ronco C., Bellomo R., Kellum J. et al. Critical Care Nephrology, Third Edition. USA: Elsevier; 2018: 54-59.Fliser D., Zeier M., Nowack R. et al. Renal functional reserve in healthy elderly subjects. J Am Soc Nephrol. 1993;3(7):1371-7.Fliser D., Zeier M., Nowack R. et al. Renal functional reserve in healthy elderly subjects. J Am Soc Nephrol. 1993;3(7):1371-7.Walker M., Nickolas T., Kepley A. et al. Predictors of renal function in primary hyperparathyroidism. The Journal of Clinical Endocrinology & Metabolism. 2014;99(5):1885-1892. doi:10.1210/jc.2013-4192Walker M., Nickolas T., Kepley A. et al. Predictors of renal function in primary hyperparathyroidism. The Journal of Clinical Endocrinology & Metabolism. 2014;99(5):1885-1892. doi:10.1210/jc.2013-4192Nair C., Babu M., Jacob P. et al. Renal dysfunction in primary hyperparathyroidism; effect of parathyroidectomy: a retrospective cohort study. International Journal of Surgery. 2016;36:383-387. doi:10.1016/j.ijsu.2016.11.009Nair C., Babu M., Jacob P. et al. Renal dysfunction in primary hyperparathyroidism; effect of parathyroidectomy: a retrospective cohort study. International Journal of Surgery. 2016;36:383-387. doi:10.1016/j.ijsu.2016.11.009Tassone F., Gianotti L., Baffoni C. et al. KDIGO categories of glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism. Endocrine Practice. 2015;21(6):629-633. doi:10.4158/ep14537.orTassone F., Gianotti L., Baffoni C. et al. KDIGO categories of glomerular filtration rate and parathyroid hormone secretion in primary hyperparathyroidism. Endocrine Practice. 2015;21(6):629-633. doi:10.4158/ep14537.orVerdelli C., Corbetta S. Mechanisms in endocrinology: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects. Eur J Endocrinol. 2017;176(1):R39-R52. doi:10.1530/eje-16-0430Verdelli C., Corbetta S. Mechanisms in endocrinology: Kidney involvement in patients with primary hyperparathyroidism: an update on clinical and molecular aspects. Eur J Endocrinol. 2017;176(1):R39-R52. doi:10.1530/eje-16-0430Nishimoto M., Murashima M., Kokubu M. et al. Pre-operative proteinuria and post-operative acute kidney injury in noncardiac surgery: the NARA-Acute Kidney Injury cohort study. Nephrology Dialysis Transplantation. 2019. doi:10.1093/ndt/gfz269Nishimoto M., Murashima M., Kokubu M. et al. Pre-operative proteinuria and post-operative acute kidney injury in noncardiac surgery: the NARA-Acute Kidney Injury cohort study. Nephrology Dialysis Transplantation. 2019. doi:10.1093/ndt/gfz269Evenepoel P., Claes K., Kuypers D. et al. Impact of parathyroidectomy on renal graft function, blood pressure and serum lipids in kidney transplant recipients: a single centre study. Nephrology Dialysis Transplantation. 2005;20(8):1714-1720. doi:10.1093/ndt/gfh892Evenepoel P., Claes K., Kuypers D. et al. Impact of parathyroidectomy on renal graft function, blood pressure and serum lipids in kidney transplant recipients: a single centre study. Nephrology Dialysis Transplantation. 2005;20(8):1714-1720. doi:10.1093/ndt/gfh892Evenepoel P., Claes K., Kuypers D. et al. Parathyroidectomy after successful kidney transplantation: a single centre study. Nephrology Dialysis Transplantation. 2007;22(6):1730-1737. doi:10.1093/ndt/gfm044Evenepoel P., Claes K., Kuypers D. et al. Parathyroidectomy after successful kidney transplantation: a single centre study. Nephrology Dialysis Transplantation. 2007;22(6):1730-1737. doi:10.1093/ndt/gfm044Montenegro F., Brandão L., Ferreira G. et al. Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands? Arquivos Brasileiros de Endocrinologia & Metabologia. 2011;55(4):249-255. doi:10.1590/s0004-27302011000400002Montenegro F., Brandão L., Ferreira G. et al. Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands? Arquivos Brasileiros de Endocrinologia & Metabologia. 2011;55(4):249-255. doi:10.1590/s0004-27302011000400002Montenegro F., Ferreira G., Lourenço D. et al. Transitory decrease of renal function after parathyroidectomy: a clinical observation indicating the renal hemodynamic effect of parathyroid hormone? Rev Bras Cir Cabeça Pescoço. 2007;36:196-201Montenegro F., Ferreira G., Lourenço D. et al. Transitory decrease of renal function after parathyroidectomy: a clinical observation indicating the renal hemodynamic effect of parathyroid hormone? Rev Bras Cir Cabeça Pescoço. 2007;36:196-201Sato T., Kikkawa Y., Yamamoto S. et al. Disrupted tubular parathyroid hormone/parathyroid hormone receptor signaling and damaged tubular cell viability possibly trigger postsurgical kidney injury in patients with advanced hyperparathyroidism. Clin Kidney J. 2019;12(5):686-692. doi:10.1093/ckj/sfy136Sato T., Kikkawa Y., Yamamoto S. et al. Disrupted tubular parathyroid hormone/parathyroid hormone receptor signaling and damaged tubular cell viability possibly trigger postsurgical kidney injury in patients with advanced hyperparathyroidism. Clin Kidney J. 2019;12(5):686-692. doi:10.1093/ckj/sfy136

The authors declare that there are no conflicts of interest present.