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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 18, 2026; 16(1): 103656
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.103656
Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.103656
Incidence, risk factors and survival outcomes of post-transplant tertiary hyperparathyroidism in kidney recipients
Shmuel Hanson, Jorge Menendez Lorenzo, Department of Medicine, University of Manchester, Manchester M13 9PL, United Kingdom
Chukwuma Austin Chukwu, Anirudh Rao, Department of Nephrology, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8YE, Mersey Side, United Kingdom
Chukwuma Austin Chukwu, Rachel Middleton, Philip A Kalra, Faculty of Biology, Medicine and Health, Department of Cardiovascular Medicine, University of Manchester, Manchester M13 9PL, United Kingdom
Rachel Middleton, Philip A Kalra, Department of Nephrology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester M6 8HD, United Kingdom
Author contributions: Hanson S, Menendez-Lorenzo J, and Chukwu CA contributed to acquisition of data and drafted the manuscript; Chukwu CA performed analysis and interpretation of data; Chukwu CA, Rao A, Middleton R, and Kalra PA initiated study concepts and design; Kalra PA provided administrative support and overall study supervision; Hanson S, Menendez Lorenzo J, Chukwu CA, Rao A, Middleton R, and Kalra PA contributed to critical revision of manuscript for intellectual content; all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by and registered with the Northern Care Alliance Research and Innovation Department in the United Kingdom (No. S21HIP03).
Informed consent statement: Patient consent was not required, as this study was based on publicly available data. The need for informed consent was waived by the Greater Manchester South Research Ethics Committee in the United Kingdom.
Conflict-of-interest statement: All authors declare no competing conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The data presented in this study are available on request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chukwuma Austin Chukwu, PhD, Department of Nephrology, Liverpool University Hospitals NHS Foundation Trust, Mount Vernon Street, Liverpool L7 8YE, Mersey Side, United Kingdom. chukwuma.chukwu@rlbuht.nhs.uk
Received: November 29, 2024
Revised: July 6, 2025
Accepted: October 11, 2025
Published online: March 18, 2026
Processing time: 414 Days and 7.9 Hours
Revised: July 6, 2025
Accepted: October 11, 2025
Published online: March 18, 2026
Processing time: 414 Days and 7.9 Hours
Core Tip
Core Tip: This study explores post-transplant tertiary hyperparathyroidism (PT-tHPT) in kidney transplant recipients, identifying elevated pre-transplant calcium and parathyroid hormone levels, prolonged dialysis duration, and acute rejection as key risk factors. PT-tHPT significantly increases the risks of graft loss and patient mortality. However, survival outcomes were comparable across treatment strategies: (1) Conservative management; (2) Calcimimetics; and (3) Parathyroidectomy. These findings highlight the need for optimized pre-transplant care and vigilant post-transplant monitoring to reduce PT-tHPT-related complications. Further research is essential to determine the most effective treatment strategy to improve outcomes and minimize morbidity and mortality associated with PT-tHPT.