scholarly journals Management of Bone Disease in Kidney Transplant Recipients

10.5772/18748 ◽  
2011 ◽  
Author(s):  
Rubin Zhang ◽  
Brent Alper
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

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 > 1.5xUNL) was seen in 48%, hypercalcemia (>10.3 mg/dL) in 18%, hypophosphatemia (<2.3 mg/dl) in 12%, and vitamin D deficiency (<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<0.001), and lower levels of phosphate (2.68 vs 3.18 mg/dL, p<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<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.

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 Bisphosphonates for preventing bone disease in kidney transplant recipients: a meta-analysis of randomized controlled trials

2015 ◽  
Vol 29 (2) ◽  
pp. 153-164 ◽  
Author(s):  
Emmanuelle B. Versele ◽  
Steven Van Laecke ◽  
Annemieke W. Dhondt ◽  
Francis Verbeke ◽  
Raymond Vanholder ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Kidney Transplant ◽  
Bone Disease ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Randomized Controlled

22. Nutrition and diet-related bone disease in adult kidney transplant recipients

2016 ◽  
pp. 437-490 ◽  
Author(s):  
E. Tantisattamo ◽  
P. Ratanasrimetha ◽  
A. Shetty ◽  
B. Ho ◽  
M. Ansari ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Adult Kidney ◽  
Nutrition And Diet

scholarly journals Interventions for preventing bone disease in kidney transplant recipients

2019 ◽  
Author(s):  
Suetonia C Palmer ◽  
Edmund YM Chung ◽  
David O McGregor ◽  
Friederike Bachmann ◽  
Giovanni FM Strippoli
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Interventions for preventing bone disease in kidney transplant recipients

2004 ◽  
Author(s):  
SC Palmer ◽  
DO McGregor ◽  
GFM Strippoli
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients

Mineral and Bone Disease in Kidney Transplant Recipients

2018 ◽  
Vol 16 (6) ◽  
pp. 703-711 ◽  
Author(s):  
Ariella M. Altman ◽  
Stuart M. Sprague
Keyword(s):  
Kidney Transplant ◽  
Bone Disease ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients
Sign in / Sign up

Export Citation Format

Share Document