Post-transplant metabolic dysregulation: Insights and implications for kidney graft survival

doi:10.5527/wjn.v15.i2.118270

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World Journal of Nephrology

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2220-6124

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Nephrol. Jun 25, 2026; 15(2): 118270
Published online Jun 25, 2026. doi: 10.5527/wjn.v15.i2.118270

Table 5 Hyperparathyroidism in kidney transplantation: Prevention, monitoring and treatment

Stage/condition	Risk factors	Drug contributions	Potential benefits of newer therapies
Pre-transplant	Long dialysis vintage, severe CKD-MBD	Steroids worsen bone loss	Calcimimetics (cinacalcet, etelcalcetide) as bridge to transplant
Post-transplant monitoring	Vitamin D deficiency, persistent hyperparathyroidism	Steroids, loop diuretics	Vitamin D analogs. Cholecalciferol supplementation
Persistent hyperparathyroidism	High PTH, hypercalcemia, hypophosphatemia	Steroids, immunosuppressants	Cinacalcet (medical therapy). Parathyroidectomy (definitive)
Late complications	Chronic graft dysfunction, bone disease	Steroids, CNIs	Denosumab. Bisphosphonates (bone protection)

CKD-MBD: Chronic kidney disease-mineral and bone disorder; PTH: Parathyroid hormone; CNIs: Calcineurin inhibitors.

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Citation: Elahi T, Ahmed S, Mubarak M. Post-transplant metabolic dysregulation: Insights and implications for kidney graft survival. World J Nephrol 2026; 15(2): 118270
URL: https://www.wjgnet.com/2220-6124/full/v15/i2/118270.htm
DOI: https://dx.doi.org/10.5527/wjn.v15.i2.118270

Elahi T, Ahmed S, Mubarak M. Post-transplant metabolic dysregulation: Insights and implications for kidney graft survival. World J Nephrol 2026; 15(2): 118270 [PMID: 42395658 DOI: 10.5527/wjn.v15.i2.118270]

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