BACKGROUND: Hyperparathyroidism (HPT) often persists after successful kidney transplantation (KTx). Although parathyroidectomy (PTx) is an effective treatment option for post-KTx HPT, it is associated with postoperative elevation of serum creatinine levels. We hypothesized that pre-PTx calcimimetic treatment could alleviate the post-PTx increase in serum creatinine levels. METHODS: This retrospective cohort study enrolled KTx patients who underwent initial PTx between 2004 and 2023. Patients' background characteristics and laboratory data were investigated. The primary outcome was a change in the estimated glomerular filtration rate (eGFR). The cohort was divided into 2 groups based on the presence of pre-PTx calcimimetic treatment. Multivariate linear regression analysis assessed the association between calcimimetic treatment and percent eGFR 1 week after PTx. RESULTS: Of the 77 KTx patients who underwent PTx, 28 were treated with pre-PTx calcimimetics (calcimimetic group), and the others were not (noncalcimimetic group). Compared with the noncalcimimetic group, the calcimimetic group had lower serum calcium levels before PTx (10.3 vs 11.2 mg/dL, P <
.001) and a significantly higher percentage of eGFR 1 week after PTx (95.1% vs 81.5%, P <
.001). According to the multivariate analysis, pre-PTx calcimimetic treatment was positively associated with percent eGFR (regression coefficient estimate, 13.76
95% confidence interval, 7.02-20.50
P <
.001) 1 week after PTx. CONCLUSION: Pre-PTx calcimimetic treatment may prevent post-PTx elevation of serum creatinine levels in KTx patients.