Incidence, risk factors and survival outcomes of post-transplant tertiary hyperparathyroidism in kidney recipients

Table 2 Univariable and multivariable logistic regression analysis of the predictors of post-transplant tertiary hyperparathyroidism

Variables	Univariable analysis				Multivariable model
	n	OR	95%CI	P value	OR	95%CI	P value
Age (per decade)	887	1.17	1.03-1.33	0.016	1.36	1.15-1.62	< 0.001
Gender: Female	887	1.10	0.75-1.62	0.62
Ethnicity	871			0.033	-	-	-
White		1	-		-	-	-
Asian1		0.49	0.24-0.89		0.33	0.14- 0.70	0.006
Black		1.85	0.51-5.41		0.79	0.16-3.02	0.75
Other		0.00	0.00-0.00		0.00	0.00-0.00	0.98
Pretransplant body mass index	887	1.00	0.98-1.03	0.71	-	-	-
Primary renal disease	887			0.044	-	-	-
Adult polycystic kidney disease		1	-		-	-	-
Glomerulonephritis		1.34	0.68-2.81		-	-	-
Diabetic kidney disease		0.79	0.31-1.94		-	-	-
Hypertensive kidney disease		1.33	0.50-3.43		-	-	-
Reflux/chronic pyelonephritis		2.70	1.32-5.79		-	-	-
Unknown		1.40	0.67-3.06		-	-	-
Other		1.63	0.72-3.73		-	-	-
Pre-emptive transplant	887	0.50	0.31-0.78	0.002
Pretransplant diabetes	887	0.88	0.51-1.44	0.61	-	-	-
Donor type: Living donor	887	0.52	0.32-0.82	0.004	-	-	-
Total human leukocyte antigen mismatch	887	1.05	0.92-1.20	0.44	-	-	-
Immunosuppression	887			0.75	-	-	-
Tacrolimus		1	-		-	-	-
Mammalian target of rapamycin inhibitor		1.68	0.37-5.47		-	-	-
Cyclosporin		0.98	0.48-1.84		-	-	-
Antimetabolite	887			0.68	-	-	-
None		-	-		-	-	-
Mycophenolic acid		0.96	0.54-1.83		-	-	-
Azathioprine		0.74	0.33-1.68		-	-	-
Corticosteroid regime	887			0.023	-	-	-
< 6 months of glucocorticoid		-	-		-	-	-
> 6 months glucocorticoid		1.55	1.06-2.28		-	-	-
Total ischaemia time	887	1.03	1.00-1.05	0.038	1.03	1.00-1.07	0.048
Dialysis vintage	887	1.19	1.12-1.26	< 0.001	1.12	1.04-1.20	0.002
Baseline eGFR (per 10 mL/minute increase)	887	0.98	0.90-1.05	0.66	-	-	-
History of acute rejection	838	1.62	0.93-2.72	0.086	2.37	1.19-4.60	0.012
The eGFR slope	887	0.93	0.89-0.97	0.001	0.91	0.87-0.96	0.001
Median pretransplant calcium (per decile increase)	887	1.35	1.25-1.46	< 0.001	1.38	1.26-1.51	< 0.001
Median pretransplant phosphate (per decile increase)	887	1.05	0.99-1.12	0.13	-	-	-
Median pretransplant parathyroid hormone (per decile increase)	887	1.26	1.17-1.36	< 0.001	1.31	1.20-1.43	< 0.001
Posttransplant diabetes	831	1.50	0.91-2.39	0.11	-	-	-
Smoking history	816			0.077			0.070
None-smoker		-	-		-	-
Current smoker		0.53	0.24-1.02		0.48	0.20-1.02

¹Ethnicity was treated as a categorical variable with "White" as the reference group, and other groups (Asian, Black, other) were included as dummy variables in the logistic regression model.

Table 2 shows the unadjusted odds ratio with 95%CI of the factors associated with post-transplant tertiary hyperparathyroidism (PT-tHPT) by the univariable and multivariable logistic regression model. The independent predictors of higher odds of PT-tHPT include age at transplantation, dialysis vintage, history of acute rejection, negative estimated glomerular filtration rate slope, higher pretransplant serum adjusted calcium and higher pretransplant serum parathyroid hormone. Asian ethnicity was associated with lower odds of PT-tHPT. eGFR: Estimated glomerular filtration rate; OR: Odds ratio.