What are the benefits and harms of using vitamin D to prevent bone disease in kidney transplant recipients?

2020 ◽  
Author(s):  
Samuel James Tingle ◽  
Emily Thompson
Keyword(s):  
Vitamin D ◽  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Denosumab-Induced Hypocalcemia and Hyperparathyroidism in de novo Kidney Transplant Recipients

2021 ◽  
pp. 1-9
Author(s):  
Giuseppe Cianciolo ◽  
Francesco Tondolo ◽  
Simona Barbuto ◽  
Francesca Iacovella ◽  
Guido Zavatta ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Kidney Transplantation ◽  
Kidney Transplant ◽  
Bone Disease ◽  
De Novo ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Mineral Density

<b><i>Introduction:</i></b> Denosumab represents a realistic treatment option to increase bone mineral density in kidney transplant recipients (KTRs). It is still unknown how and at what extent posttransplantation bone disease and graft function influence the effects of denosumab on mineral metabolism indexes. In this study, we analyze risk factors of hypocalcemia and parathyroid hormone (PTH) increase after denosumab administration in eighteen de novo KTRs and its management before and after this treatment. <b><i>Methods:</i></b> We conducted a monocentric, observational, prospective study on de novo KTRs. All KTRs enrolled received a single 60 mg subcutaneous dose of denosumab every 6 months. Before kidney transplantation, no patients were treated with calcio-mimetic. After kidney transplantation and before antiresorptive therapy, no patients were treated with calcio-mimetic drugs and/or vitamin D receptor agonists, while all patients received nutritional vitamin D supplementation (from 1,000 IU to 1,500 IU daily). <b><i>Results:</i></b> Hypocalcemia was related to the degree of lumbar osteoporosis (<i>p</i> = 0.047); the increase in the PTH level was correlated to baseline bone turnover markers (bone alkaline phosphatase, serum osteocalcin, and β-C-terminal telopeptide), the 25 OH status, and eGFR. The introduction of calcitriol, after the PTH increase, in addition to cholecalciferol was necessary to ensure an adequate control of serum calcium and PTH during a follow-up of 15 months. Following the treatment with denosumab, it was observed an improvement of areal bone mineral density both at lumbar and femoral sites with a mean percentual increase of 1.74% and 0.25%, respectively. <b><i>Conclusions:</i></b> Denosumab is an effective treatment for bone disease in KTRs. In our study, the increase in PTH is not a transient event but prolonged throughout the follow-up period and requires continuous supplementation therapy with calcitriol.

FC 124PATTERNS OF RENAL OSTEODYSTROPHY ONE YEAR AFTER KIDNEY TRANSPLANTATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Hanne Skou Jørgensen ◽  
Geert Behets ◽  
Patrick D'Haese ◽  
Pieter Evenepoel
Keyword(s):  
Kidney Transplantation ◽  
Bone Turnover ◽  
Kidney Transplant ◽  
Renal Osteodystrophy ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Post Transplant ◽  
Steroid Dose ◽  
Bone Biopsies

Abstract Background and Aims Bone disease after kidney transplantation is an issue of growing concern, as prolonged graft survival and older age of recipients necessitate focus on long-term health burdens such as osteoporosis and fractures. Pre-existing type of renal osteodystrophy, post-transplant immunosuppressive treatment, and de novo disturbances of mineral metabolism all contribute to bone disease in kidney transplant recipients. The current pattern of renal osteodystrophy after kidney transplantation is not well characterized. This study reports histomorphometric findings of protocolled bone biopsies in a large cohort of kidney transplant recipients 1 year post-transplant. Method Histomorphometric analysis of transiliac bone biopsies with prior tetracycline labelling was performed in 141 kidney transplant recipients. Biochemical measurements included bioactive parathyroid hormone (PTH), total calcium, phosphate, calcidiol, bicarbonate, and sclerostin. Kruskal-Wallis and Wilcoxon signed rank tests were used to evaluate differences across categories and between groups, respectively. Stepwise multivariate linear regression was performed to identify key demographic and biochemical determinants of bone turnover (bone formation rate, BFR), mineralization (mineralization lag time, Mlt), and volume (Bone area, BAr). Results Mean age was 57±11 years, 71% were men, and all were Caucasian. Mean eGFR was 49±16 (range 19 to 106) ml/min/1.73 m². Hyperparathyroidism (PTH &gt; 1.5xUNL) was seen in 48%, hypercalcemia (&gt;10.3 mg/dL) in 18%, hypophosphatemia (&lt;2.3 mg/dl) in 12%, and vitamin D deficiency (&lt;15 ng/mL) in 4% of patients. Categorization of bone turnover, mineralization, and volume is shown in Figure 1. Bone turnover was normal in the vast majority (71%). Patients with low turnover (26%) had received a higher cumulative steroid dose (2.78 vs 2.34g in low vs non-low turnover; p=0.02). Patients with delayed mineralization (16%) were younger (52 vs 58 yrs, p=0.02) and had received a higher cumulative steroid dose (2.85 vs 2.36g, p=0.003). They had higher levels of PTH (124 vs 53 ng/L, p&lt;0.001), and lower levels of phosphate (2.68 vs 3.18 mg/dL, p&lt;0.001), calcidiol (29 vs 37ug/L, p=0.02), bicarbonate (21.3 vs 23.3 mmol/L, p=0.004), and sclerostin (493 vs 594 pg/mL, p=0.03) compared to patients with normal mineralization. Patients with low bone volume tended to be older (61 vs 56 years, p=0.07). Independent determinants of BFR were PTH (β=0.68, p&lt;0.001) and cumulative steroid dose (β = -0.22, p=0.02). Determinants of Mlt were phosphate (β=-0.48, p=0.001) and cumulative steroid dose (β=0.18, p=0.004), and determinants of BAr were age (β=-0.15, p=0.002), and BMI (β=0.33, p=0.002). Conclusion Bone turnover is normal in the majority of kidney transplant recipients at 1 year post-transplant, despite a high prevalence of hyperparathyroidism. Low levels of bicarbonate, phosphate, and calcidiol may contribute to delayed bone mineralization in kidney transplant recipients.

scholarly journals Low 25(OH) Vitamin-D levels are associated with inferior graft function in living related kidney transplant recipients

2018 ◽  
Vol 7 (4) ◽  
pp. 224-229
Author(s):  
Sonia Mehrotra ◽  
Raj Kumar Sharma ◽  
Amit Gupta ◽  
Narayan Prasad ◽  
Dharmendra S. Bhadauria ◽  
...  
Keyword(s):  
Vitamin D ◽  
Kidney Transplant ◽  
Graft Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D ◽  
Living Related

Vitamin D deficiency and infection risk in kidney transplant recipients: A single-center cohort study

2018 ◽  
Vol 20 (6) ◽  
pp. e12988 ◽  
Author(s):  
Mario Fernández-Ruiz ◽  
Laura Corbella ◽  
Alejandra Morales-Cartagena ◽  
Esther González ◽  
Natalia Polanco ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cohort Study ◽  
Vitamin D Deficiency ◽  
Kidney Transplant ◽  
Infection Risk ◽  
Transplant Recipients ◽  
Single Center ◽  
Kidney Transplant Recipients

EFFECTIVE REPLACEMENT OF 25-OH VITAMIN D IN KIDNEY TRANSPLANT RECIPIENTS.

2010 ◽  
Vol 90 ◽  
pp. 691
Author(s):  
S. Akkina ◽  
P. Anattiwong ◽  
M. Campara ◽  
A. Lau ◽  
I. Y. Tang
Keyword(s):  
Vitamin D ◽  
Kidney Transplant ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
25 Oh Vitamin D

scholarly journals Vitamin D Deficiency in Kidney Transplant Recipients: Risk Factors and Effects of Vitamin D3 Supplements

2009 ◽  
Vol 41 (6) ◽  
pp. 2388-2390 ◽  
Author(s):  
R. Marcén ◽  
B. Ponte ◽  
N. Rodríguez-Mendiola ◽  
A. Fernández-Rodriguez ◽  
C. Galeano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Kidney Transplant ◽  
Vitamin D3 ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Management of Metabolic Bone Disease in Kidney Transplant Recipients

2008 ◽  
Vol 335 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Rubin Zhang ◽  
Brent Alper ◽  
Eric Simon ◽  
Sandy Florman ◽  
Douglas Slakey
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Metabolic Bone

scholarly journals Relationship between vitamin D status and immunosuppressive therapy in kidney transplant recipients

2015 ◽  
Vol 29 (2) ◽  
pp. 331-335 ◽  
Author(s):  
Jean Jeanov Filipov ◽  
Borelli Kirilov Zlatkov ◽  
Emil Paskalev Dimitrov ◽  
Dobrin Svinarov
Keyword(s):  
Vitamin D ◽  
Immunosuppressive Therapy ◽  
Kidney Transplant ◽  
Vitamin D Status ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Seasonal Variation of Vitamin D Status in Long-Term Kidney Transplant Recipients

2017 ◽  
Vol 49 (9) ◽  
pp. 2086-2091 ◽  
Author(s):  
J. Wilimborek ◽  
M. Nowicki ◽  
I. Kurnatowska
Keyword(s):  
Vitamin D ◽  
Seasonal Variation ◽  
Kidney Transplant ◽  
Vitamin D Status ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients
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