transplantologiyaТрансплантологияTransplantologiya. The Russian Journal of Transplantation2074-05062542-0909IPO Association of Transplantologists10.23873/2074-0506-2017-9-2-137-152transplantologiya-168Research ArticleОБЗОРНЫЕ СТАТЬИ И ЛЕКЦИИREVIEW ARTICLES AND LECTURESТрансплантация почки и гиперпаратиреозKidney transplantation and hyperparathyroidismВетчинниковаО. Н.VetchinnikovaO. N.

д-р мед. наук, старший научный сотрудник хирургического отделения трансплантологии и диализа МОНИКИ им. М.Ф. Владимирского, Москва, Россия

Dr. Med. Sci., Senior Researcher of Surgical Department of Transplantation and Dialysis at Moscow Regional Research and Clinical Institute n.a. M.F. Vladimirskiy

olg-vetchinnikova@yandex.ruГБУЗ МО МОНИКИ им. М.Ф. ВладимирскогоРоссияMoscow Regional Research and Clinical Institute n.a. M.F. VladimirskiyRussian Federation20172406201792137152Copyright © Ветчинникова О.Н., 20172017Ветчинникова О.Н.Vetchinnikova O.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jtransplantologiya.ru/jour/article/view/168

Успешная трансплантация почки нивелирует эндокринно-метаболические нарушения, предрасполагающие к формированию закономерного для хронической болезни почек осложнения – гиперпаратиреоза, однако процесс восстановления минерально-костных нарушений замедлен. Наибольшая частота посттрансплантационного гиперпаратиреоза регистрируется в первый послеоперационный год. К факторам риска его развития или персистенции относят высокие уровни в крови паратиреоидного гормона, кальция, фосфора и (или) щелочной фосфатазы, длительную диализную терапию, тяжелый гиперпаратиреоз в предоперационном периоде, дефицит витамина D, субоптимальную функцию трансплантированной почки, а также ранее перенесенную реципиентом субтотальную или неполную паратиреоидэктомию. Характерными клиническими и лабораторными признаками посттрансплантационного гиперпаратиреоза являются поражения костей, почечного трансплантата, гиперкальциемия и гипофосфатемия. Диагностический алгоритм включает динамическое определение маркеров минерального и костного метаболизма, минеральной плотности кости и визуализацию околощитовидных желез. Коррекцию посттрансплантационного гиперпаратиреоза проводят хирургическим путем или медикаментозными средствами. Анализируют показания, объем и сроки выполнения паратиреоидэктомии. Обсуждается применение препаратов нативного витамина D, его аналогов и кальцимиметиков.

Successful kidney transplantation eliminates endocrine and metabolic disorders that predispose to the development of hyperparathyroidism, the complication typical for the chronic kidney disease; but the process of recovery from mineral and bone disorders is slowed down. The highest incidence of post-transplant hyperparathyroidism is recorded in the first postoperative year. The risk factors for its development or persistence include the high blood levels of parathyroid hormone, calcium, phosphorus, and/or alkaline phosphatase, a prolonged dialysis therapy, severe hyperparathyroidism in the preoperative period, vitamin D deficiency, a suboptimal transplanted kidney function, and also the recipient's previous history of subtotal or incomplete parathyroidectomy. The characteristic clinical and laboratory signs of posttransplant hyperparathyroidism are bone lesions, kidney graft abnormalities, hypercalcemia, and hypophosphatemia. The diagnostic algorithm includes monitoring the markers of mineral and bone metabolism, determining the bone mineral density, and imaging of thyroid glands. Correction of post-transplant hyperparathyroidism is performed surgically or pharmacologically. The article specifies the indications to, the extent and timing of parathyroidectomy, discusses the use of native vitamin D formulations, its analogues, and calcimimetics.

трансплантация почкигиперпаратиреозтопическая диагностикапаратиреоидэктомиявитамин Dkidney transplantationhyperparathyroidismtopical diagnosisparathyroidectomyvitamin DReferencesCunningham J., Locatelli F., Rodriguez M. Secondary Hyperparathyroidism: Pathogenesis, Disease Progression and Therapeutic Options. Clin. J. Am. Soc. Nephrol. 2011;6(4):913– 921. PMID:21454719 DOI:10.2215/CJN.06040710Cunningham J., Locatelli F., Rodriguez M. Secondary Hyperparathyroidism: Pathogenesis, Disease Progression and Therapeutic Options. Clin J Am Soc Nephrol. 2011;6(4):913– 921. PMID:21454719 DOI:10.2215/CJN.06040710Jamal S.A., Miller P.D. Secondary and Tertiary Hyperparathyroidism. J. Clin. Densitometry: Assessment of Skeletal Health. 2013;16(1):64–68. PMID:2326774 DOI:101016/j.jocd.2012.11.012Jamal S.A., Miller P.D. Secondary and Tertiary Hyperparathyroidism. J Clin Densitometry: Assessment of Skeletal Health. 2013;16(1):64–68. PMID:2326774 DOI:101016/j.jocd.2012.11.012Evenepoel P. Recovery versus persistence of disordered mineral metabolism in kidney transplant recipients. Semin. Nephrol. 2013;33(2):191–203. PMID:23465505 DOI:10.1016/j.semnephrol.2012.12.019Evenepoel P. Recovery versus persistence of disordered mineral metabolism in kidney transplant recipients. Semin Nephrol. 2013;33(2):191–203. PMID:23465505 DOI:10.1016/j.semnephrol.2012.12.019Ветчинникова О.Н., Шестеро Е.В., Егорова Е.А. Минерально-костные нарушения у реципиентов почечного трансплантата. Нефрология. 2016;20(6):49–56. DOI:10.24884/1561-6274-2016-6-49-56Vetchinnikova O.N., Shestero E.V., Egorova E.A. Mineral and bone disorders in renal transplant recipients. Nephrology (Saint-Petersburg). 2016;20(6):49–56. (In Russian). DOI:10.24884/1561-6274-2016-6-49-56Perrin P., Caillard S., Javier R.M. Et al. Persistent hyperparathyroidism is a major risk factor for fractures in the five years after kidney transplantation. Am. J. Transplant. 2013;13(10):2653–2663. PMID:24034142 DOI:10.1111/ajt.12425Perrin P., Caillard S., Javier R.M., et al. Persistent hyperparathyroidism is a major risk factor for fractures in the five years after kidney transplantation. Am J Transplant. 2013;13(10):2653–2663. PMID: 24034142 DOI:10.1111/ajt.12425Wolf M., Weir M.R., Kopyt N. et al. Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. Transplantation. 2016;100(1):184–189. PMID:26177089 DOI:10.1097/TP.0000000000000823Wolf M., Weir M.R., Kopyt N., et al. Prospective Cohort Study of Mineral Metabolism After Kidney Transplantation. Transplantation. 2016;100(1):184– 189. PMID:26177089 DOI:10.1097/TP.0000000000000823Tillmann F.-P., Wächtler C., Hansen A. et al. Vitamin D and cinacalcet administration pre-transplantation predict hypercalcaemic hyperparathyroidism post-transplantation: a case-control study of 355 deceased-donor renal transplant recipients over 3 years. Transplantation Research. 2014;3(3):21–26. PMID:25606342 DOI:10.1186/s13737-014-0021-5Tillmann F.-P., Wächtler C., Hansen A., et al. Vitamin D and cinacalcet administration pre-transplantation predict hypercalcaemic hyperparathyroidism post- transplantation: a case-control study of 355 deceased-donor renal transplant recipients over 3 years. Transplantation Research. 2014;3(3):21–26. PMID:25606342 DOI:10.1186/s13737-014-0021-5Grethen E., Hill K.M., Jones R., Cacucci B.M. et al. Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J. Clin. Endocrinol. Metab. 2012;97(5):1655–1662. PMID:22362819 DOI:10.1210/jc.2011-2280Grethen E., Hill K.M., Jones R., et al. Serum leptin, parathyroid hormone, 1,25- dihydroxyvitamin D, fibroblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J Clin Endocrinol Metab. 2012;97(5):1655–1662. PMID:22362819 DOI:10.1210/jc.2011-2280Ермоленко В.М., Волгина Г.В., Михайлова Н.А. и др. Лечение минеральных и костных нарушений при хронической болезни почек. Нефрология. Клинические рекомендации. Ред.: Шилов Е.М., Смирнов А.В., Козловская Н.Л. М.: ГЭОТАР-Медиа, 2016. 687–709.Ermolenko V.M., Volgina G.V., Mikhaylova N.A., et al. Treatment of mineral and bone disorders in chronic kidney disease. In: Shilov E.M., Smirnov A.V., Kozlovs kaya N.L., eds. Nephrology. Clinical recommendations. Moscow: GEOTARMedia Publ., 2016. 687–709. (In Russian).Bleskestad I.H., Bergrem H., Leivestad T. et al. Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function. Clin. Transplant. 2014;28:479–486. PMID:25649861 DOI:10.1111/ctr12341Bleskestad I.H., Bergrem H., Leivestad T., et al. Parathyroid hormone and clinical outcome in kidney transplant patients with optimal transplant function. Clin Transplant. 2014;28:479–486.PMID:25649861 DOI:10.1111/ctr12341Evenepoel P., Claes K., Kuypers D. et al. Natural history of parathyroid function and calcium metabolism after kidney transplantation: A singlecentre study. Nephrol. Dial. Transplant. 2004;19(5):1281–1287. PMID:14993493 DOI:10.1093/ndt/gfh128Evenepoel P., Claes K., Kuypers D., et al. Natural history of parathyroid function and calcium metabolism after kidney transplantation: A singlecentre study. Nephrol Dial Transplant. 2004;19(5):1281–1287. PMID:14993493 DOI:10.1093/ndt/gfh128Scillitani A., Guarnieri V., De Geronimo S. et al. Blood ionized calcium is associated with clustered polymorphisms in the carboxyl-terminal tail of the calcium-sensing receptor. J. Clin. Endocrinol.Metab. 2004;89(11):5634–5638. PMID:15531522 DOI:10.1210/jc.2004-0129Scillitani A., Guarnieri V., De Geronimo S., et al. Blood ionized calcium is associated with clustered polymorphisms in the carboxyl-terminal tail of the calcium-sensing receptor. J Clin Endocrinol Metab. 2004;89(11):5634–5638. PMID:15531522 DOI:10.1210/jc.2004-0129Weidong W., Chunling L. Reduce expression of renal Na+ transporter in rats with PTH-induced hypercalcemia. Am. J. Physiol. Renal. Physiol. 2004;286(3):534–545. PMID:14625199 DOI:10.1152/ajprenal.00044.2003Weidong W., Chunling L. Reduce expression of renal Na+ transporter in rats with PTH-induced hypercalcemia. Am J Physiol Renal Physiol. 2004;286(3):534–545. PMID:14625199 DOI:10.1152/ajprenal.00044.2003D’Marco L., Bellasi A., Mazzaferro S., Raggi P. Vascular calcification, bone and mineral metabolism after kidney transplantation. World J. Transplant. 2015;5(4):222–230. DOI:10.5500/wjt.v5.i4.222D’Marco L., Bellasi A., Mazzaferro S., Raggi P. Vascular calcification, bone and mineral metabolism after kidney transplantation. World J Transplant. 2015;5(4):222– 230. DOI:10.5500/wjt.v5.i4.222Egbuna O.I., Taylor J.G., Bushinsky D.A., Zand M.S. Elevated calcium phosphate product after renal transplantation is a risk factor for graft failure. Clin. Transplant. 2007;21(4):558–566. PMID:17645720 DOI:10.1111/j.1399-0012.2007.00690.xEgbuna O.I., Taylor J.G., Bushinsky D.A., Zand M.S. Elevated calcium phosphate product after renal transplantation is a risk factor for graft failure. Clin Transplant. 2007;21(4):558–566. PMID:17645720 DOI:10.1111/j.1399-0012.2007.00690.xKawarazaki H., Shibagaki Y., Fukumoto S. et al. Natural History of Mineral and Bone Disorders After Living-Donor Kidney Transplantation: A One-Year Prospective Observational Study. Ther. Apher. Dial. 2011;15(5):481–487. PMID:21974702 DOI:10.1111/j.1744-9987.2011.00932.xKawarazaki H., Shibagaki Y., Fukumoto S., et al. Natural History of Mineral and Bone Disorders After Living-Donor Kidney Transplantation: A One-Year Prospective Observational Study. Ther Apher Dial. 2011;15(5):481–487. PMID:21974702 DOI:10.1111/j.1744-9987.2011.00932.xBleskestad I.H., Thorsen I.S., Jonsson G. et al. Soluble Klotho and intact fibroblast growth factor 23 in longterm kidney transplant patients. Eur. J. Endocrinol. 2015;172(4):343–350. PMID: 25572388 DOI:10.1530/EJE-14-0457Bleskestad I.H., Thorsen I.S., Jonsson G., et al. Soluble Klotho and intact fibroblast growth factor 23 in long-term kidney transplant patients. Eur J Endocrinol. 2015;172(4):343–350. PMID:25572388 DOI:10.1530/EJE-14-0457Tomida K., Hamano T., Ichimaru N. et al. Dialysis vintage and parathyroid hormone level, not fibroblast growth factor-23, determines chronic-phase phosphate wasting after renal transplantation. Bone. 2012;51(4):729–736. PMID:2796419 DOI:10.1016/j.bone.2012.06.027Tomida K., Hamano T., Ichimaru N., et al. Dialysis vintage and parathyroid hormone level, not fibroblast growth factor- 23, determines chronic-phase phosphate wasting after renal transplantation.Bone. 2012;51(4):729–736. PMID:2796419 DOI:10.1016/j.bone.2012.06.027Hiemstra T.F., Brown A.J., Chaudhry A.N., Walsh M. Association of calcium, phosphate and parathyroid hormone with renal allograft function: a retrospective cohort study. Am. J. Nephrol. 2013;37(4):339–345. PMID:23548209 DOI:10.1159/000348376Hiemstra T.F., Brown A.J., Chaudhry A.N., Walsh M. Association of calcium, phosphate and parathyroid hormone with renal allograft function: a retrospective cohort study. Am J Nephrol. 2013;37(4):339–345. PMID:23548209 DOI:10.1159/000348376KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl. 2009;113:S1–S130. PMID:19644521 DOI:10.1038/ki.2009.188KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease- Mineral and Bone Disorder (CKD-MBD). Kidney Int Suppl. 2009;113:S1-S130. PMID:19644521 DOI:10.1038/ki.2009.188Alshayeb H.M., Josephson M.A., Sprague S.M. CKD – Mineral and Bone Disorder Management in Kidney Transplant Recipients. Am. J. Kidney Dis. 2013;61(2):310–325. PMID:23102732 DOI:10.1053/j.ajkd.2012.07.022Alshayeb H.M., Josephson M.A., Sprague S.M. CKD – Mineral and Bone Disorder Management in Kidney Transplant Recipients. Am J Kidney Dis. 2013;61(2):310–325. PMID:23102732 DOI:10.1053/j.ajkd.2012.07.022Ketteler M., Elder G.J, Evenepoel P. et al. Revisiting KDIGO clinical practice guideline on chronic kidney disease mineral and bone disorder: a commentary from a Kidney Disease: Improving Global Outcomes controversies conference. Kidney Int. 2015(3);87:502–528. PMID:25651364 DOI:10.1038/ki.2014.425Ketteler M., Elder G.J, Evenepoel P., et al. Revisiting KDIGO clinical practice guideline on chronic kidney disease mineral and bone disorder: a commentary from a Kidney Disease: Improving Global Outcomes controversies conference. Kidney Int. 2015(3);87:502–528. PMID:25651364 DOI:10.1038/ki.2014.425Naylor K.L., Zou G., Leslie W.D. et al. Frequency of bone mineral density testing in adult kidney transplant recipients from Ontario, Canada: a populationbased cohort study. Canadian Journal of Kidney Health and Disease. 2016;3(3):2– 9. PMID:26779343 PMCID:PMC4715326 DOI:10.1186/s40697-016-0092-yNaylor K.L., Zou G., Leslie W.D., et al. Frequency of bone mineral density testing in adult kidney transplant recipients from Ontario, Canada: a populationbased cohort study. Canadian Journal of Kidney Health and Disease. 2016;3(3):2–9. PMID:26779343 PMCID:PMC4715326 DOI:10.1186/s40697-016-0092-yNaylor K.L., Jamal S.A., Zou G.Y. Et al. Fracture incidence in adult kidney transplant recipients. Transplantation. 2016;100(1):167–175. PMID:26154389 DOI:10.1097/TP.0000000000000808Naylor K.L., Jamal S.A., Zou G.Y., et al. Fracture incidence in adult kidney transplant recipients. Transplantation. 2016;100(1):167–175. PMID:26154389 DOI:10.1097/TP.0000000000000808Nishiyama K.K., Pauchard Y., Nikkel L.E. et al. Longitudinal HR-pQCT and Image Registration Detects Endocortical Bone Loss in Kidney Transplantation Patients. Journal of Bone and Mineral Research. 2015;30(3):554–561. PMID:25213758 DOI:10.1002/jbmr.2358Nishiyama K.K., Pauchard Y., Nikkel L.E., et al. Longitudinal HR-pQCT and Image Registration Detects Endocortical Bone Loss in Kidney Transplantation Patients. Journal of Bone and Mineral Research. 2015;30 (3):554–561. PMID:25213758 DOI:10.1002/jbmr.2358Методы визуализации околощитовидных желез и паратиреоидная хирургия: руководство для врачей. Под ред. А.П. Калинина. Москва: Издательский дом Видар-М, 2010. 311 с.Kalinin A.P., ed. Methods of visualization of parathyroid glands and parathyroid surgery: a guide for physicians. Moscow: Izdatel'skiy dom Vidar-M Publ., 2010. 311 p. (In Russian).Захарова Н.М., Ветчинникова О.Н., Иванцова Л.П. Цитологическая диагностика гиперпаратиреоза. Клиническая лабораторная диагностика. 2014;59(12):36–40.Zakharova N.M., Vetchinnikova O.N., Ivantsova L.P. Cytological diagnosis of hyperparathyroidism. Clinical laboratory diagnostics. 2014;59(12):36–40. (In Russian).Захарова Н.М., Ветчинникова О.Н., Иванцова Л.П. Цитоморфологические особенности паращитовидных желез при различных формах гиперпаратиреоза. Клиническая лабораторная диагностика. 2016;61(10):697–700.Zakharova N.M., Vetchinnikova O.N., Ivantsova L.P. Cytomorphological features of parathyroid glands with various forms of hyperparathyroidism. Clinical laboratory diagnostics. 2016;61(10):697– 700. (In Russian).Kievit A.J., Tinnemans J.G.M., Idu M.M. et al. Outcome of Total Parathyroidectomy and Autotransplantation as Treatment of Secondary and Tertiary Hyperparathyroidism in Children and Adults. World J. Surg. 2010;34(5):993–1000. PMID:20145928 PMCID:PMC2848726 DOI 10.1007/s00268-010-0446-zKievit A.J., Tinnemans J.G.M., Idu M.M., et al. Outcome of Total Parathyroidectomy and Autotransplantation as Treatment of Secondary and Tertiary Hyperparathyroidism in Children and Adults. World J Surg. 2010;34(5):993–1000. PMID:20145928 PMCID:PMC2848726 DOI:10.1007/s00268-010-0446-zPark J.H., Kang S.-W., Jeong J.J. et al. Surgical treatment of tertiary hyperparathyroidism after renal transplantation: A 31-year experience in a single institution. Endocrine Journal. 2011;58(10):827–833. PMID:21804261Park J.H., Kang S.-W., Jeong J.J., et al. Surgical treatment of tertiary hyperparathyroidism after renal transplantation: A 31-year experience in a single institution. Endocrine Journal. 2011;58(10):827–833. PMID:21804261Lou I., Schneider D.F., Leverson G. Et al. Parathyroidectomy is underused in patients with tertiary hyperparathyroidism after renal transplantation. Surgery. 2016;159(1):172–179. PMID:26603850 PMCID:PMC4688142 DOI:10.1016/j.surg.2015.08.039Lou I., Schneider D.F., Leverson G., et al. Parathyroidectomy is underused in patients with tertiary hyperparathyroidism after renal transplantation. Surgery. 2016;159(1):172–179. PMID:26603850 PMCID:PMC4688142 DOI:10.1016/j.surg.2015.08.039Ferreira G.F., Montenegro F.L.M., Machado D.J. et al. Parathyroidectomy after kidney transplantation: shortand long- term impact on renal function. CLINICS. 2011;66(3): 431–435. PMID:21552668Ferreira G.F., Montenegro F.L.M., Machado D.J., et al. Parathyroidectomy after kidney transplantation: short- and long-term impact on renal function. CLINICS. 2011;66(3):431–435. PMID:21552668Akaberi S., Clyne N., Sterner G. Et al. Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population – a nationwide, population-based study 1991–2009. BMC Nephrol. 2014;15:75–81. PMID:24886448PMCI DOI:10.1186/1471-2369-15-75.Akaberi S., Clyne N., Sterner G., et al. Temporal trends and risk factors for parathyroidectomy in the Swedish dialysis and transplant population – a nationwide, population-based study 1991–2009. BMC Nephrol. 2014;15:75–81. PMID:24886448PMCI DOI:10.1186/1471-2369-15-75Dewberry L.K., Weber C., Sharma J. Near total parathyroidectomyn is effective therapy for tertiary hyperparathyroidism. Am. Surg. 2014;80(7):646–651. PMID:24987894Dewberry L.K., Weber C., Sharma J. Near total parathyroidectomyn is effective therapy for tertiary hyperparathyroidism. Am Surg. 2014;80(7):646–651. PMID:24987894Messa P., Regalia A., Alfieri C.M. et al. Current indications to parathyroidectomy in CKD patients before and after transplantation. J. Nephrol. 2013;26(6):1025–1032. PMID:24284524 DOI:10.5301/jn.5000277Messa P., Regalia A., Alfieri C.M., et al. Current indications to parathyroidectomy in CKD patients before and after transplantation. J Nephrol. 2013;26(6):1025–1032. PMID:24284524 DOI:10.5301/jn.5000277Torregrosa J.V., Barros X. Management of hypercalcemia after renal transplantation. Nefrologia. 2013;33(6):751– 757. PMID:24241361 DOI:10.3265/Nefrologia.pre2013.Aug.11888Torregrosa J.V., Barros X. Management of hypercalcemia after renal transplantation. Nefrologia. 2013;33(6):751–757. PMID:24241361 DOI:10.3265/Nefrologia.pre2013.Aug.11888Yang R.L., Freeman K., Reinke C.E. et al. Tertiary Hyperparathyroidism in kidney transplant recipients: Characteristics of patients selected for different treatment strategies. Transplantation. 2012;94(1):70–76. PMID:22706321 DOI:10.1097/TP.0b013e3182530699Yang R.L., Freeman K., Reinke C.E., et al. Tertiary Hyperparathyroidism in kidney transplant recipients: Characteristics of patients selected for different treatment strategies. Transplantation. 2012;94(1):70–76. PMID:22706321 DOI:10.1097/TP.0b013e3182530699Martin T.J. Osteoblast-derived PTHrP is a physiological regulator of bone formation. J. Clin. Invest. 2005;115(9):2322–2324. PMID:16138187 PMC1193889 DOI:10.1172/JCI26239Martin T.J. Osteoblast-derived PTHrP is a physiological regulator of bone formation. J Clin Invest. 2005;115(9):2322– 2324. PMID:16138187 PMC1193889 DOI:10.1172/JCI26239Hsieh T.M., Sun C.K., Chen Y.T., Chou F.F. Total parathyroidectomy versus subtotal parathyroidectomy in the treatment of tertiary hyperparathyroidism. Am. Surg. 2012;78(5):600–606. PMID:22546135Hsieh T.M., Sun C.K., Chen Y.T., Chou F.F. Total parathyroidectomy versus subtotal parathyroidectomy in the treatment of tertiary hyperparathyroidism. Am Surg. 2012;78(5):600–606. PMID:22546135Miao D., He B., Jiang Y. et al. Osteoblast-derived PTHrP is a potent endogenous bone anabolic agent that modifies the therapeutic efficacy of administered PTH 1-34. J. Clin. Invest. 2005;115(9):2402–2411. PMID:16138191 PMCID:PMC1193882 DOI:10.1172/JCI24918Miao D., He B., Jiang Y., et al. Osteoblast-derived PTHrP is a potent endogenous bone anabolic agent that modifies the therapeutic efficacy of administered PTH 1-34. J Clin Invest. 2005;115(9):2402–2411. PMID:16138191 PMCID:PMC1193882 DOI:10.1172/JCI24918Sadideen H.M., Taylor J.D., Goldsmith D.J. Total parathyroidectomy without autotransplantation after renal transplantation for tertiary hyperparathyroidism: long-term follow-up. Int. Urol. Nephrol. 2012;44(1):275–281. PMID:21997202 DOI:10.1007/s11255-011-0069-9Sadideen H.M., Taylor J.D., Goldsmith D.J. Total parathyroidectomy without autotransplantation after renal transplantation for tertiary hyperparathyroidism: long-term follow-up. Int Urol Nephrol. 2012;44(1):275–281. PMID:21997202 DOI:10.1007/s11255-011-0069-9Schlosser K., Rothmund M., Maschuw K. et al. Graft-dependent Renal Hyperparathyroidism Despite Successful Kidney Transplantation. World J. Surg. 2008;32(4):557–565. PMID:18204949 DOI:10.1007/s00268-007-9337-3Schlosser K., Rothmund M., Maschuw K., et al. Graft-dependent Renal Hyperparathyroidism Despite Successful Kidney Transplantation. World J Surg. 2008;32(4):557–565. PMID:18204949 DOI:10.1007/s00268-007-9337-3Pitt S.C., Panneerselvan R., Chen H., Sippel R.S. Secondary and Tertiary Hyperparathyroidism: The Utility of ioPTH Monitoring. World J. Surg.2010;34(6):1343–1349. PMID:20386902 PMCID:PMC290574 DOI:10.1007/s00268-010-0575-4Pitt S.C., Panneerselvan R., Chen H., Sippel R.S. Secondary and Tertiary Hyperparathyroidism: The Utility of ioPTH Monitoring. World J Surg. 2010;34(6):1343– 1349. PMID:20386902 PMCID:PMC2905743 DOI:10.1007/s00268-010-0575-4Nogueira E.L., Costa A.C., Santana A. et al. Teriparatide efficacy in the treatment of severe hypocalcemia after kidney transplantation in parathyroidectomized patients: a series of five case reports. Transplantation. 2011;92(3):316– 320. PMID:21694663 DOI:10.1097/TP.0b013e3182247b98Nogueira E.L., Costa A.C., Santana A., et al. Teriparatide efficacy in the treatment of severe hypocalcemia after kidney transplantation in parathyroidectomized patients: a series of five case reports. Transplantation. 2011;92(3):316–320. PMID:21694663 DOI:10.1097/TP.0b013e3182247b98Schwarz A., Rustien G., Merkel S. et al. Decreased renal transplant function after parathyroidectomy. Nephrol. Dial. Transplant. 2007;22(2):584–591. PMID:17035377 DOI:10.1093/ndt/gfl583Schwarz A., Rustien G., Merkel S., et al. Decreased renal transplant function after parathyroidectomy. Nephrol Dial Transplant. 2007;22(2):584–591. PMID:17035377DOI:10.1093/ndt/gfl583Schlosser K., Endres N., Celik I. et al. Surgical treatment of tertiary hyperparathyroidism: the choice of procedure matters! World J. Surg. 2007;31(10):1947–1953. PMID:17665243 DOI:10.1007/s00268-007-9187-zSchlosser K., Endres N., Celik I., et al. Surgical treatment of tertiary hyperparathyroidism: the choice of procedure matters! World J Surg. 2007;31(10):1947–1953. PMID:17665243 DOI:10.1007/s00268-007-9187-zKalantar-Zadeh K., Molnar M.Z., Kovesdy C.P. et al. Management Mineral and Bone Disorder after Kidney Transplantation. Curr. Opin. Nephrol. Hypertens. 2012;21(4):389–403. PMID:22614626 DOI:10.1097/MNH.0b013e3283546ee0Kalantar-Zadeh K., Molnar M.Z., Kovesdy C.P., et al. Management Mineral and Bone Disorder after Kidney Transplantation. Curr Opin Nephrol Hypertens. 2012;21(4):389– 403. PMID: 22614626 DOI:10.1097/MNH.0b013e3283546ee0Courbebaisse M., Alberti C., Colas S. et al. VITamin D supplementation in renAL transplant recipients (VITALE): a prospective, multicentre, double-blind, randomized trial of vitamin D estimating the benefit and safety of vitamin D3 treatment at a dose of 100,000 UI compared with a dose of 12,000 UI in renal transplant recipients: study protocol for a double-blind, randomized, controlled trial. Trials. 2014;15:430–443. PMID:25376735 PMCID:PMC4233037 DOI:10.1186/1745-6215-15-430Courbebaisse M., Alberti C., Colas S., et al. VITamin D supplementation in renAL transplant recipients (VITALE): a prospective, multicentre, double-blind, randomized trial of vitamin D estimating the benefit and safety of vitamin D3 treatment at a dose of 100,000 UI compared with a dose of 12,000 UI in renal transplant recipients: study protocol for a double-blind, randomized, controlled trial. Trials. 2014;15:430–443. PMID:25376735 PMCID:PMC4233037 DOI:10.1186/1745-6215-15-430Amer H., Griffin M.D., Stegall M.D. Et al. Oral Paricalcitol Reduces the Prevalence of Posttransplant Hyperparathyroidism: Results of an Open Label Randomized Trial. Am. J. Transplant. 2013;13:1576–1585. PMID:23601186 DOI:10.1002/ajt.12227Amer H., Griffin M.D., Stegall M.D., et al. Oral Paricalcitol Reduces the Prevalence of Posttransplant Hyperparathyroidism: Results of an Open Label Randomized Trial. Am J Transplant. 2013;13:1576–1585. PMID:23601186 DOI:10.1002/ajt.12227Gonzalez E., Rojas-Rivera J., Polanco N. et al. Effects of Oral Paricalcitol on Secondary Hyperparathyroidism and Proteinuria of Kidney Transplant Patients. Transplantation. 2013;95(7):e49–e52. PMID:23545517 DOI:10.1097/TP.0b013e3182855565Gonzalez E., Rojas-Rivera J., Polanco N., et al. Effects of Oral Paricalcitol on Secondary Hyperparathyroidism and Proteinuria of Kidney Transplant Patients. Transplantation. 2013;95(7):e49–e52. PMID:23545517 DOI:10.1097/TP.0b013e3182855565Pérez V., Sánchez-Escuredo A., Lauzurica R. et al. Magnetic bead-based proteomic technology to study paricalcitol effect in kidney transplant recipients. Eur. J. Pharmacol. 2013;709(1–3):72–79. PMID:23567070 DOI:10.1016/j.ejphar.2013.03.040Pérez V., Sánchez-Escuredo A., Lauzurica R., et al. Magnetic bead-based proteomic technology to study paricalcitol effect in kidney transplant recipients. Eur J Pharmacol. 2013;709(1– 3):72–79. PMID:23567070 DOI:10.1016/j.ejphar.2013.03.040Trillini M., Cortinovis M., Ruggenenti P. et al. Paricalcitol for Secondary Hyperparathyroidism in Renal Transplantation. J. Am. Soc. Nephrol. 2015;26(5):1205–1214. PMID:25194004 DOI:10.1681/ASN.2013111185Trillini M., Cortinovis M., Ruggenenti P., et al. Paricalcitol for Secondary Hyperparathyroidism in Renal Transplantation. J Am Soc Nephrol. 2015;26(5):1205– 1214. PMID:25194004 DOI:10.1681/ASN.2013111185Borrego Utiel F.J., Bravo Soto J.A., Merino Pérez M.J. et al. Effect of paricalcitol on mineral bone metabolism in kidney transplant recipients with se condary hyperparathyroidism. Nefrologia. 2015;35(4):363–373. PMID:26306956 DOI:10.1016/j.nefro.2015.06.018Borrego Utiel F.J., Bravo Soto J.A., Merino Pérez M.J., et al. Effect of paricalcitol on mineral bone metabolism in kidney transplant recipients with se condary hyperparathyroidism. Nefrologia. 2015;35(4):363–373. PMID:26306956 DOI:10.1016/j.nefro.2015.06.018Ветчинникова О.Н., Кантария Р.О. Терапевтическая тактика при третичном гиперпаратиреозе после трансплантации почки (обзор литературы и клинические наблюдения). Клиническая нефрология. 2014;1:55–63.Vetchinnikova O.N., Kantariya R.O. Therapeutic tactics in tertiary hyperparathyroidism after renal transplantation (review and clinical observations). Clinical Nephrology. 2014;1:55–63. (In Russian).Ветчинникова О.Н., Щербакова Е.О., Полякова Е.Ю. Цинакальцет в лечении гиперпаратиреоза у реципиентов почечного трансплантата. Вестник трансплантологии и искусственных органов. 2014;16(1):47– 53. DOI:10.15825/1995-1191-2014-1-47-53Vetchinnikova O.N., Shcherbakova E.O., Polyakova E.Yu. Cinacalcet in treatment of hyperparathyroidism in recipients of renal graft. Russian Journal of Transplantology and Artificial Organs. 2014;16(1):47–53. (In Russian). DOI:10.15825/1995-1191-2014-1-47-53Thiem U., Alois Gess A., Borchhardt K. Long-Term Clinical Practice Experience with Cinacalcet for Treatment of Hypercalcemic Hyperparathyroidism after Kidney Transplantation. BioMed Research International. 2015; 2015: 12 p. ID 292654. Режим доступа: https://www.hindawi.com/journals/bmri/2015/292654/ DOI:10.1155/2015/292654Thiem U., Alois Gess A., Borchhardt K. Long-Term Clinical Practice Experience with Cinacalcet for Treatment of Hypercalcemic Hyperparathyroidism after Kidney Transplantation. BioMed Research International. 2015;2015:12. ID 292654. Available at: https://www.hindawi.com/journals/bmri/2015/292654/ DOI:10.1155/2015/292654Okada M., Tominaga Y., Izumi K. et al. Tertiary Hyperparathyroidism Resistant to Cinacalcet Treatment. Ther. Apher. Dial. 2011;15(Suppl 1):33–37. PMID:21595850 DOI:10.1111/j.1744-9987.2011.00924.xOkada M., Tominaga Y., Izumi K., et al. Tertiary Hyperparathyroidism Resistant to Cinacalcet Treatment. Ther Apher Dial. 2011;15(Suppl 1):33–37. PMID:21595850 DOI:10.1111/j.1744-9987.2011.00924.xCohen J.B., Gordon C.E., Balk E.M., Francis J.M. Cinacalcet for the treatment of hyperparathyroidism in kidney transplant recipients: a systematic review and meta-analysis. Transplantation. 2012;94(10):1041–1048. PMID:23069843 DOI:10.1097/TP.0b013e31826c3968Cohen J.B., Gordon C.E., Balk E.M., Francis J.M. Cinacalcet for the treatment of hyperparathyroidism in kidney transplant recipients: a systematic review and meta- analysis. Transplantation. 2012;94(10):1041–1048. PMID:23069843 DOI:10.1097/TP.0b013e31826c3968Evenepoel P., Cooper K., Holdaas H. et al. A Randomized Study Evaluating Cinacalcet to Treat Hypercalcemia in Renal Transplant Recipients With Persistent Hyperparathyroidism. Am. J. Transplant. 2014;14(11):2545–2555. PMID:25225081DOI:10.1111/ajt.12911Evenepoel P., Cooper K., Holdaas H., et al. A Randomized Study Evalu ating Cinacalcet to Treat Hypercalcemia in Renal Transplant Recipients With Persistent Hyperparathyroidism. Am J Transplant. 2014;14(11):2545–2555. PMID:25225081 DOI:10.1111/ajt.12911

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