Patients and methods: 15 patients, 6 males and 9 females with a mean age of 50.5±13.5 years and on treatment with cyclosporine, everolimus (1.5 or 3 mg/ day) and prednisone (CsA-EVE) were included in the study. The group was compared with another 15 renal transplant recipients transplanted immediately before and treated with tacrolimus, mycophenolate mofetil and prednisone (TAC-MMF). Measurements of BMD were done by dual-energy X-ray absortiometry (DEXA) at the lumbar vertebral bodies L2-L4 and in the right femoral neck at the time of transplant and at 1 year.. Results: In CsA-EVE patients, lumbar spine BMD decreased from 0.860±0.201 g/cm2 at baseline to 0.822±0.199 g/cm2 at 1 year (p<0.05). Femoral neck BMD slightly increased, it was 0.800±0.239 g/cm2 at baseline and 0.787±0.179 g/cm2 at 1 year (NS). There was a tendency to higher bone loss with the higher everolimus dose. On the contrary, lumbar spine BMD did not signifi cantly change in recipients on TAC-MMF, lumbar spine BMD at baseline was 0.980±0.150 g/cm2 and 0.959±0.119 at 1 year. Femoral neck BMD increased from 0.825±0.199 at baseline to 0.866±0.166 g/cm2 at 1 year. There were no differences between the groups in age at transplant, sex distribution, number of post-menopausal women, time on dialysis, body mass index at transplant, graft function at 12 months (SCr 1.4±0.3 mg/dl in TAC-MMF vs 1.6±0.7 mg/dl in CsA-Eve; NS), iPTH levels at the time of transplant and at 12 months. Conclusions: Our fi ndings do not support the hypothesis that immunosuppression with everolimus could have bone-sparing effects. But the number of patients is too small to draw defi nitive conclusions.