Is secondary hyperparathyroidism-related myelofibrosis a negative prognostic factor for kidney transplant outcome?

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Abstract

Secondary hyperparathyroidism (HP) presenting with hypocalcemia and subsequent increased parathormone (PTH), is mainly identified in patients with chronic renal failure, which has been associated with variable degrees of bone marrow fibrosis. For suitable patients with end-stage renal disease (ESRD), kidney transplantation is recognized as the therapy of choice, being superior to dialysis in terms of quality of life and long-term mortality risk; in this regard interesting data show that increased time on dialysis prior to kidney transplantation is associated with decreased graft and patient survival. In our opinion an important and until now underestimated determinant of graft survival is the proper activity of bone marrow because of the emerging role of hematopoietic stem cells (HSC) in repair of ischemia/reperfusion (IR) damage. We postulate that in ESRD patients, who usually undergo long dialytic treatment, a myelofibrosis caused by an overt secondary HP could drastically decrease the HSC potential for IR damage repair after kidney transplant; this could irremediably lead to a delay in graft function with all related complicances. If the curative role of bone marrow-derived stem cells was confirmed by more data obtained in experimental animal models, it could be possible to try a cellular-based therapeutic approach in the management of ESRD patients which are in waiting list for a kidney transplant.
Lingua originaleEnglish
pagine (da-a)557-559
Numero di pagine3
RivistaMedical Hypotheses
Volume77
Stato di pubblicazionePublished - 2011

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Primary Myelofibrosis
Secondary Hyperparathyroidism
Chronic Kidney Failure
Transplants
Kidney
Graft Survival
Hematopoietic Stem Cells
Reperfusion Injury
Kidney Transplantation
Dialysis
Ischemia
Bone Marrow
Waiting Lists
Hypocalcemia
Parathyroid Hormone
Stem Cells
Therapeutics
Animal Models
Quality of Life
Mortality

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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@article{bbb13e37874b4ae78142c7c64c2d5115,
title = "Is secondary hyperparathyroidism-related myelofibrosis a negative prognostic factor for kidney transplant outcome?",
abstract = "Secondary hyperparathyroidism (HP) presenting with hypocalcemia and subsequent increased parathormone (PTH), is mainly identified in patients with chronic renal failure, which has been associated with variable degrees of bone marrow fibrosis. For suitable patients with end-stage renal disease (ESRD), kidney transplantation is recognized as the therapy of choice, being superior to dialysis in terms of quality of life and long-term mortality risk; in this regard interesting data show that increased time on dialysis prior to kidney transplantation is associated with decreased graft and patient survival. In our opinion an important and until now underestimated determinant of graft survival is the proper activity of bone marrow because of the emerging role of hematopoietic stem cells (HSC) in repair of ischemia/reperfusion (IR) damage. We postulate that in ESRD patients, who usually undergo long dialytic treatment, a myelofibrosis caused by an overt secondary HP could drastically decrease the HSC potential for IR damage repair after kidney transplant; this could irremediably lead to a delay in graft function with all related complicances. If the curative role of bone marrow-derived stem cells was confirmed by more data obtained in experimental animal models, it could be possible to try a cellular-based therapeutic approach in the management of ESRD patients which are in waiting list for a kidney transplant.",
author = "Palumbo, {Vincenzo Davide} and Giuseppe Buscemi and Roberta Altomare and Giuseppe Damiano and Gioviale, {Maria Concetta} and {Lo Monte}, {Attilio Ignazio} and Francesco Cacciabaudo and Maurizio Bellavia",
year = "2011",
language = "English",
volume = "77",
pages = "557--559",
journal = "Medical Hypotheses",
issn = "0306-9877",
publisher = "Churchill Livingstone",

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TY - JOUR

T1 - Is secondary hyperparathyroidism-related myelofibrosis a negative prognostic factor for kidney transplant outcome?

AU - Palumbo, Vincenzo Davide

AU - Buscemi, Giuseppe

AU - Altomare, Roberta

AU - Damiano, Giuseppe

AU - Gioviale, Maria Concetta

AU - Lo Monte, Attilio Ignazio

AU - Cacciabaudo, Francesco

AU - Bellavia, Maurizio

PY - 2011

Y1 - 2011

N2 - Secondary hyperparathyroidism (HP) presenting with hypocalcemia and subsequent increased parathormone (PTH), is mainly identified in patients with chronic renal failure, which has been associated with variable degrees of bone marrow fibrosis. For suitable patients with end-stage renal disease (ESRD), kidney transplantation is recognized as the therapy of choice, being superior to dialysis in terms of quality of life and long-term mortality risk; in this regard interesting data show that increased time on dialysis prior to kidney transplantation is associated with decreased graft and patient survival. In our opinion an important and until now underestimated determinant of graft survival is the proper activity of bone marrow because of the emerging role of hematopoietic stem cells (HSC) in repair of ischemia/reperfusion (IR) damage. We postulate that in ESRD patients, who usually undergo long dialytic treatment, a myelofibrosis caused by an overt secondary HP could drastically decrease the HSC potential for IR damage repair after kidney transplant; this could irremediably lead to a delay in graft function with all related complicances. If the curative role of bone marrow-derived stem cells was confirmed by more data obtained in experimental animal models, it could be possible to try a cellular-based therapeutic approach in the management of ESRD patients which are in waiting list for a kidney transplant.

AB - Secondary hyperparathyroidism (HP) presenting with hypocalcemia and subsequent increased parathormone (PTH), is mainly identified in patients with chronic renal failure, which has been associated with variable degrees of bone marrow fibrosis. For suitable patients with end-stage renal disease (ESRD), kidney transplantation is recognized as the therapy of choice, being superior to dialysis in terms of quality of life and long-term mortality risk; in this regard interesting data show that increased time on dialysis prior to kidney transplantation is associated with decreased graft and patient survival. In our opinion an important and until now underestimated determinant of graft survival is the proper activity of bone marrow because of the emerging role of hematopoietic stem cells (HSC) in repair of ischemia/reperfusion (IR) damage. We postulate that in ESRD patients, who usually undergo long dialytic treatment, a myelofibrosis caused by an overt secondary HP could drastically decrease the HSC potential for IR damage repair after kidney transplant; this could irremediably lead to a delay in graft function with all related complicances. If the curative role of bone marrow-derived stem cells was confirmed by more data obtained in experimental animal models, it could be possible to try a cellular-based therapeutic approach in the management of ESRD patients which are in waiting list for a kidney transplant.

UR - http://hdl.handle.net/10447/59381

M3 - Article

VL - 77

SP - 557

EP - 559

JO - Medical Hypotheses

JF - Medical Hypotheses

SN - 0306-9877

ER -