Bone mineral density after renal transplantation in children

Feber, Janusz; Cochat, Pierre; Braillon, P.; Castelo, Fernanda; Martín, Xavier; Glastre, Catherine; Chapuis, François; David, L; Meunier, Pierre J.

doi:10.1007/bf00860941

Cited by 17 publications

(26 citation statements)

References 8 publications

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“…We did not measure the true volumetric BMD with peripheral quantitative computer tomography or perform bone histomorphometry, which would have been preferable (10), however, peripheral quantitative computer tomography was not available at study start (in 2001). Despite correction for height and volume, DXA does not allow the assessment of bone quality where the gold standard for bone quality assessment is represented by invasive bone biopsy (29). Peripheral quantitative computer tomography can differentiate cortical and trabecular bone structure, which can to a higher extent predict the 3‐dimensional structure and bone strength.…”

Section: Discussionmentioning

confidence: 99%

Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover

2009

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Section: Discussionmentioning

confidence: 99%

Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover

2009

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“…In pediatric renal Tx patients, the findings are not uniform (9). Feber et al (10) in a longitudinal study showed that the greatest decrease in BMD was observed during the first 6 months following Tx. Subsequent stabilization or normalization was noted as late as 12 and 24 months after Tx.…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density in pediatric and adolescent renal transplant patients: How to evaluate

Gökşen¹,

Darcan²,

Kara

et al. 2005

Pediatric Transplantation

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Reduced bone mass is a common complication of renal transplantation in adults but only few data are present for pediatric transplant patients. Bone mineral status of pediatric renal transplant patients ages ranging from 7.5 to 17.6 years (mean age 14.9 +/- 2.3) who were at least 6 months postrenal transplantation was examined. Bone mineral density (BMD) of lumbar vertebrea and femoral neck was determined by dual energy X-ray absorptiometry (DEXA) and z-scores according to age, puberty, height and bone age were compared to sex and ethnic specific reference data. z-scores were calculated for both areal and volumetric bone density. BMD L1-4 z-scores were more than 2 SD below the mean according to chronological age in 12 patients (63%), pubertal status in six patients (31.5%), bone age in five patients (26.3%) and height in five patients (26.3%). The BMD femoral neck z-scores were more than 2 SD below the mean according to age in 10 patients (55.5%), puberty in five patients (27.7%), bone age in three (16.6%) patients and height in five (26.3%) patients. Correction of the vertebrae and femoral neck for bone size yielded osteoporotic values for seven patients (36.8%) for lumbar BMD and for four patients (22%) for femoral neck BMD. The use of aBMD in growth-retarded children has some restrictions in determining z-scores. Deficits in spinal bone density still persisted after correcting for height, puberty, bone age and volume. In renal transplant patients who have short stature it is reasonable to give values corrected for height, puberty, bone age and bone size and interpret each of these values for each patient.

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“…The findings of bone health of pediatric renal transplant recipients remain controversial. One prospective study showed a marked decrease in size-adjusted spine BMD during the first 2 years after transplantation (41). A second study found continuing losses in spine BMD even after transplantation in those patients receiving methylprednisolone (42).…”

Section: Discussionmentioning

confidence: 99%

A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents

El‐Husseini¹,

El‐Agroudy

El‐Sayed

et al. 2004

American Journal of Transplantation

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The effect of treatment with alfacalcidol on posttransplantation bone loss in children and adolescents was investigated.Of the 63 young patients who received renal transplant and were subjected to dual-energy x-ray absorptiometry (DEXA), 30 patients had low-bone mineral density (BMD) (z-score ≤ −1) and were enrolled into the study. Their mean age at the time of transplantation was 14.5 ± 4.0 years and the mean duration after transplantation was 48 ± 34 months. Patients with low BMD were randomized into two equal homogeneous groups: group 1 (control) received placebo and group 2 received daily alfacalcidol 0.25 lg by mouth. Parameters of bone metabolism (intact parathyroid hormone, serum osteocalcin and urinary deoxypyridinoline) and BMD were assessed before and after the study period.After 12 months of treatment BMD at the lumber spine decreased from −2.2 to −2.5 in group 1 while it increased from −2.1 to −0.6 in group 2 (p < 0.001). Serum intact parathyroid hormone level decreased significantly in group 2 (p = 0.042). Apart from transient hypercalcemia in 1 patient in group 2, no other significant adverse effects were noted. This study suggested the value of alfacalcidol in the treatment of bone loss in young renal transplant recipients.

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Bone mineral density after renal transplantation in children

Cited by 17 publications

References 8 publications

Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover

Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover

Bone mineral density in pediatric and adolescent renal transplant patients: How to evaluate

A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents

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