Bone disease after renal transplantation

Malluche, Hartmut H.; Monier‐Faugere, Marie‐Claude; Herberth, Johann

doi:10.1038/nrneph.2009.192

Cited by 91 publications

(98 citation statements)

References 105 publications

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“…More recent publications of prospective trials that included patients managed with contemporary immunosuppression protocols have reported bone loss of only 0.1%-5.7% in the lumbar spine (4). After 1 year, BMD remains relatively stable with no further decline but at significantly lower levels than healthy controls (2). This reduction in BMD contributes to an increased risk of fractures.…”

Section: Epidemiologymentioning

confidence: 99%

Bone Disease after Kidney Transplantation

Bouquegneau

Salam

Delanaye

et al. 2016

CJASN

126

109

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Bone and mineral disorders occur frequently in kidney transplant recipients and are associated with a high risk of fracture, morbidity, and mortality. There is a broad spectrum of often overlapping bone diseases seen after transplantation, including osteoporosis as well as persisting high-or low-turnover bone disease. The pathophysiology underlying bone disorders after transplantation results from a complex interplay of factors, including preexisting renal osteodystrophy and bone loss related to a variety of causes, such as immunosuppression and alterations in the parathyroid hormone-vitamin D-fibroblast growth factor 23 axis as well as changes in mineral metabolism. Management is complex, because noninvasive tools, such as imaging and bone biomarkers, do not have sufficient sensitivity and specificity to detect these abnormalities in bone structure and function, whereas bone biopsy is not a widely available diagnostic tool. In this review, we focus on recent data that highlight improvements in our understanding of the prevalence, pathophysiology, and diagnostic and therapeutic strategies of mineral and bone disorders in kidney transplant recipients.

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Section: Epidemiologymentioning

confidence: 99%

Bone Disease after Kidney Transplantation

Bouquegneau

Salam

Delanaye

et al. 2016

CJASN

126

109

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“…In bone tissue, unlike calcineurin, sirolimus may inhibits osteoclasts differentiation and thus may be considered a bone-sparing immunosuppressive agent (8).…”

Section: Sirolimusmentioning

confidence: 99%

Bone disease after transplantation: osteoporosis and fractures risk

Kulak

Borba

Kulak

et al. 2014

Arq Bras Endocrinol Metab

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Organ transplantation is the gold standard therapy for several end-stage diseases. Bone loss is a common complication that occurs in transplant recipients. Osteoporosis and fragility fractures are serious complication, mainly in the first year post transplantation. Many factors contribute to the pathogenesis of bone disease following organ transplantation. This review address the mechanisms of bone loss including the contribution of the immunosuppressive agents as well as the specific features to bone loss after kidney, lung, liver, cardiac and bone marrow transplantation. Prevention and management of bone loss in the transplant recipient should be included in their post transplant follow-up in order to prevent fractures. Arq Bras Endocrinol Metab. 2014;58(5):484-92Keywords Transplantation; bone loss; osteoporosis; fractures; immunosuppressive agents RESUMOTransplantes de órgão é terapia padrão-ouro para várias doenças em estágio terminal. Perda óssea é uma complicação comum que ocorre em pacientes transplantados. Osteoporose e fraturas por fragilidade são complicações sérias, principalmente no primeiro ano pós-transplante. Muitos fatores podem contribuir para patogênese da doença óssea nesses pacientes. Esta revisão aborda os mecanismos de perda óssea incluindo o papel dos agentes imunossupressores, bem como os fatores específicos da perda óssea após rim, pulmão, fígado, coração e transplante de medula óssea. A prevenção e o tratamento da perda óssea nos pacientes transplantados devem ser realizados para evitar fraturas. Arq Bras Endocrinol Metab. 2014;58(5):484-92 Descritores

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“…Pyridinoline, deoxypryridinoline, crosslinked N-terminal telopeptides of type I collagen and C-terminal telopeptides of type I collagen are markers used to evaluate bone resorption (Kusec and Smalcelj, 2004). BAP reflects an increase in bone turnover and is useful for monitoring bone formation (Malluche and Claude, 2010). However, BAP is thought to be an unpredictable marker because heterogeneous factors, such as the duration of dialysis, secondary hyperparathyroidism, aluminum osteomalacia and postoperative glucocorticoid therapy, influence bone metabolism (Rix and Andreassen, 1999).…”

Section: Discussionmentioning

confidence: 99%

Pre-transplantation and post-transplantation serum bone alkaline phosphatase levels in renal transplant patients

Gümüş¹,

Öztürk²,

Düz³

et al. 2014

jecm

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Article HistoryReceived 03 / 05 / 2014 Accepted 12 / 06 / 2014Bone Alkaline Phosphatase (BAP) reflects the biosynthetic activity of the osteoblasts. End-stage renal disease and renal transplantation have effects on bone metabolism. The aim of this study was to evaluate serum BAP levels in pre-transplantation (pre-tx) and post-transplantation (post-tx) samples obtained from patients who underwent a renal transplantation. Forty end-stage renal disease patients (16 male and 24 female) undergoing transplantation and 40 healthy individuals (20 female and 20 male) volunteered for this study. The serum samples were obtained before the onset of immunosuppressive treatment and two months after renal transplantation. Serum BAP levels were measured by Ostease Kit (Beckman Coulter, California, USA) at DXI 800 immunoassay autoanalyzer. There were significant differences between control group and pre-tx group (p=0.015) and between control group and post-x group (P<0.001). The serum BAP levels were lower in the post-tx group than that of the control group the control group, but this difference was not statistically significant (p=0.023). These results suggest that osteoblast activity is suppressed during chronic renal failure and transplantation worsens osteoblastic inactivity, thus causing to enter a non-dynamic state the bone. BAP may be a useful parameter for assessing the metabolic status of bone before and after renal transplantation.

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Bone disease after renal transplantation

Cited by 91 publications

References 105 publications

Bone Disease after Kidney Transplantation

Bone Disease after Kidney Transplantation

Bone disease after transplantation: osteoporosis and fractures risk

Pre-transplantation and post-transplantation serum bone alkaline phosphatase levels in renal transplant patients

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