Changes in Bone Mineral Density and Selected Metabolic Parameters Over 24 Months Following Renal Transplantation
Section snippets
Patients and methods
The cohort included 40 renal transplant recipients (19 women and 21 men of average age 49.5 ± 15.2 years), who all had serum creatinine concentrations below 200 μmol/L subgroub A with creatinine concentrations < 120 μmol/L; subgroup B with creatinine concentrations 120 to 200 μmol/L). All patients were treated with a combination of cyclosporine, mycophenolate mofetil or azathioprine. They were prophylactically given 1000 mg calcium effervescent tablets and 800 IU of vitamins A and D. None of
Results
The results are shown separately for subgroup A of recipients with creatinine concentration less than 120 μmol/L and subgroup B of recipients with creatinine concentration in the range of 120 to 200 μmol/L (Table 1, Table 2, Table 3). Among subgroup A, at 2 years after the renal transplant, the average PTH concentration was 82.92 ± 66.01 pg/mL, while in subgroup B, it was 140.34 ± 150.41 pg/mL (Table 1). Two years after transplantation, the 20 individuals with creatinine concentration < 120
Discussion
Renal osteopathy after a successful kidney transplantation is a frequent complication, characterized by low bone mineral density with increased fracture incidence, osteonecrosis, and bone pain.1 The alterations of bone remodeling after transplantation are heterogeneous; most studies show a decrease in bone formation in the face of persistently elevated bone resorption.2 This imbalance in remodeling favoring resorption leads to a progressive loss of bone mass and to an increased risk of fracture.
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Cited by (22)
Vitamin D and organ transplantation
2023, Feldman and Pike's Vitamin D: Volume Two: Disease and TherapeuticsOsteoporosis in organ transplant patients
2020, Marcus and Feldman’s OsteoporosisEffects of Cyclosporine, Tacrolimus, and Rapamycin on Osteoblasts
2017, Transplantation ProceedingsSirolimus and tacrolimus rather than cyclosporine A cause bone loss in healthy adult male rats
2015, Bone ReportsCitation Excerpt :With the use of new and more powerful immunosuppressive drugs, survival rates in patients receiving solid-organ transplantation have improved significantly due to effective control of acute rejection episodes. However, a substantial number of works describe the development of osteoporosis among patients who have received transplantation of organs such as the kidney, heart, or liver (Monegal et al., 2001; Al-Gabri et al., 2005; Maalouf and Shane, 2005; Kulak et al., 2012; Wang et al., 2013; Monegal et al., 2013). These patients have increased risk of vertebral and nonvertebral fracture (Ramsey-Goldman et al., 1999).
Osteoporosis in Organ Transplant Patients
2013, Osteoporosis: Fourth EditionLow graft function and ongoing hyperparathyroidism are closely related to post-transplantation osteoporosis
2013, Transplantation ProceedingsCitation Excerpt :Renal osteopathy includes high bone turnover of secondary hyperparathyroidism (fibrosis osteodystrophy) and osteopathy with low bone turnover of the osteomalacia type or adynamic bone disease. Mixed forms of osteopathy with participation of all these mechanisms occur most frequently.12 Preventing long-term complications of RT, such as bone disease, has become an essential part of posttransplant care.
The study was supported by grants IGA MZ CR NK/7741-3 and MSM 151100004.