Hypercalcaemia following renal transplantation: A common problem of limited clinical consequence?

Tertiary hyperparathyroidism manifesting as hypercalcaemia, is common after renal transplantation. It often resolves within the first few years, but i n previous studies has been associated with bone, renal and cardiovascular pathology, There have been no large studies in the last 10 years, or in pat ients treated predominantly with Cyclosporin A, that have examined the long -term effect of this condition on patient or transplant outcomes, A retrosp ective analysis was conducted of 171 consecutive renal transplant recipient s with at least 1 year of graft survival from 1984 to 1996. Measurement was made of current and past incidence of hypercalcaemia, the natural history of posttransplant hypercalcaemia, and its effect on graft survival and func tion, and patient mortality, The incidence of hypercalcaemia was 26% and di d not change significantly during the time frame of the study. The average serum calcium increased until 6 months post-transplantation, and then stead ily decreased over the next 7 years. There was a significant variation in t he rate of decrease between subjects, No long-term effect on patient or gra ft survival or function was detected. Post-transplant hypercalcaemia usuall y represents a benign condition that resolves with time. A conservative app roach is recommended in the management of most patients in this group.