Lumbar Bone Mineral Density in Renal Transplant Patients on Neoral and Tacrolimus: A Four-Year Prospective Study

Marcén, R.; Caballero, Carmen; Pascual, Julio; Teruel, J.L.; Tenorio, Maite; Ocaña, Javier; Villafruela, J.J.; Burgos, Francisco; Fernandez, Armida; Muriel, Alfonso; Ortuño, J

doi:10.1097/01.tp.0000203557.36884.e3

Cited by 53 publications

(41 citation statements)

References 26 publications

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“…Temporal changes in BMD for femoral neck and lumbar spine were similar across studies assessing BMD over multiple time points [12, 15, 18, 20, 22, 39]. In general, BMD decreased in both the femoral neck and lumbar spine the first 3 months after transplant.…”

Section: Resultsmentioning

confidence: 62%

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Abnormal Bone and Mineral Metabolism in Kidney Transplant Patients – A Review

et al. 2007

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Background/Aims: Abnormal bone and mineral metabolism is common in patients with kidney failure and often persists after successful kidney transplant. Methods: To better understand the natural history of this disease in transplant patients, we reviewed the literature by searching MEDLINE for English language articles published between January 1990 and October 2006 that contained Medical Subject Headings and key words related to secondary or persistent hyperparathyroidism and kidney transplant. Results: Parathyroid hormone levels decreased significantly during the first 3 months after transplant but typically stabilized at elevated values after 1 year. Calcium tended to increase after transplant and then stabilize at the higher end of the normal range within 2 months. Phosphorus decreased rapidly to within or below normal levels after surgery and hypophosphatemia, if present, resolved within 2 months. Low levels of 1,25(OH)₂ vitamin D typically did not reach normal values until almost 18 months after transplant. Conclusion: This review provides evidence demonstrating that abnormal bone and mineral metabolism exists in patients after kidney transplant and suggests the need for treatment of this condition. However, better observational and interventional research is needed before advocating such a treatment guideline.

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Section: Resultsmentioning

confidence: 62%

“…Low bone mineral density (BMD; T score <–2.5) was frequently diagnosed in kidney transplant patients [24, 25,34,35,36,37,38,39,40,41]. Averaging all data, the percent of patients with low BMD from primarily cortical bone sites was greater than that from primarily trabecular bone sites (fig.…”

Section: Resultsmentioning

confidence: 99%

Abnormal Bone and Mineral Metabolism in Kidney Transplant Patients – A Review

et al. 2007

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“…However, its effect on bone metabolism in humans is less clear. Tacrolimus appears to have less adverse effect on bone than cyclosporine [30] . The effects of mycophenolic acid, sirolimus, everolimus and belatacept on bone remodeling remain unknown.…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%

Metabolic bone diseases in kidney transplant recipients

Zhang

Chouhan²

2012

WJN

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Metabolic bone disease after kidney transplantation has a complex pathophysiology and heterogeneous histology. Pre-existing renal osteodystrophy may not resolve completely, but continue or evolve into a different osteodystrophy. Rapid bone loss immediately after transplant can persist, at a lower rate, for years to come. These greatly increase the risk of bone fracture and vertebral collapse. Each patient may have multiple risk factors of bone loss, such as steroids usage, hypogonadism, persistent hyperparathyroidism (HPT), poor allograft function, metabolic acidosis, hypophosphatemia, vitamin D deficiency, aging, immobility and chronic disease. Clinical management requires a comprehensive approach to address the underlying and ongoing disease processes. Successful prevention of bone loss has been shown with vitamin D, bisphosphonates, calcitonin as well as treatment of hypogonadism and HPT. Novel approach to restore the normal bone remodeling and improve the bone quality may be needed in order to effectively decrease bone fracture rate in kidney transplant recipients.

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“…However, the effect of cyclosporine on bone metabolism in humans is less clear, being confounded by the presence of other illnesses or drugs that affect bone, particularly glucocorticoids. Tacrolimus appears to have less adverse effect on bone than cyclosporine (Marcen et al, 2006). The effects of other immunosuppressive medicines such as mycophenolate mofetil and sirolimus on bone remodeling remain unknown.…”

Section: Immunosuppressive Drugsmentioning

confidence: 99%