Osteoporosis After Renal Transplantation: Single Center Experience

Abstract

Time since transplantation and cumulative prednisolone doses were significantly higher in patients who had osteoporosis of the lumbar vertebrae (P=0.06 and 0.034, respectively). Logistic regression analysis revealed that cumulative prednisolone dose was the only significant predictor of low vertebral BMD (P=0.02, r=0.33). For the neck of the femur, high blood urea nitrogen and low Mg levels were found to be the predictors of low bone density (P=0.002 and 0.04, respectively). Although parathyroid hormone levels were higher in femoral osteoporosis patients than in those not affected at this site, the difference was not statistically significant (P=0.294). Time since transplantation, cumulative prednisolone dose, and cyclosporine A dose were all found to have a major negative impact on BMD in the radius region (P=0.001, 0.000, 0.001, respectively). Regression analysis showed that cumulative prednisolone dose (P=0.0008, r=0.34), time since transplantation (P=0.005, r=0.27), body mass index (P=0.01, r=-0.21), male gender (P=0.02, r=-0.21), and age (P=0.04, r=0.16) all had major effects on radius BMD. In conclusion, the radius seems to be one of the major parts of the skeleton affected by factors introduced after renal transplantation.

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

“…Length of dialysis was not associated with the severity of BMD loss in kidney transplant patients [15, 20, 28, 33, 39,43,44,45], although one study reported a significant correlation between T scores and dialysis duration for the femoral neck and radius but not the spine [37]. Similarly, kidney function in kidney transplant patients was not associated with BMD [25, 30, 31, 33, 39, 40, 44, 45].…”

“…Similarly, kidney function in kidney transplant patients was not associated with BMD [25, 30, 31, 33, 39, 40, 44, 45]. …”

Bone disease after renal transplantation

“…Both, ciclosporine and tacrolimus use have been linked to osteoporosis in clinical studies, 33,34 and progression of bone loss with calcineurin inhibitor monotherapies has been demonstrated in rodent models. 35,36 Despite these findings, population-based studies that have focused on fracture risk could not establish an association between use of calcineurin inhibitors and fracture risk.…”

Preventing Bone Loss in Renal Transplant Recipients with Vitamin D

“…In patients with renal transplants, in addition to known risk factors for bone loss in healthy populations, other abnormalities could negatively affect the bone metabolism, including the pretransplantation renal osteodystrophy, persistent hyperparathyroidism, and use of immunosuppressive drugs (5). The role of glucocorticoids-induced osteoporosis is well documented in many series (6), and there is much evidence that cyclosporin A (CsA) could increase bone resorption as a result of increased osteoclast activity (7,8).…”