Early bone mineral density loss after renal transplantation and pre-transplant PTH: a prospective study

Kidney Blood Press Res. 2008;31(3):196-202. doi: 10.1159/000137287. Epub 2008 Jun 6.

Abstract

Background: Post-transplant osteopathy is a known complication of kidney transplantation (KTx). The aim of this study was to assess bone mineral density (BMD) in a large cohort of patients with treatment depending on pre-transplant parathormone (PTH) and baseline BMD.

Patients and methods: 347 consecutive KTx recipients (222 M, 125 F) finished all follow-up measurements of BMD at lumbar spine, femur and radius using DEXA Lunar (at baseline and at 6 and 18 months).

Results: Bone loss with a T-score below -2.5 affected 37.2% of patients before KTx. A negative correlation between baseline PTH and BMD was found (p < 0.01). Patients with high levels of PTH had more bone loss than patients with low PTH values (p < 0.01). In the lumbar spine, a decline of BMD was found in the first 6 months, and after 18 months an improvement was found in all subgroups (p < 0.001). In femur, significant changes were found only in low-PTH patients after 6 months (p < 0.001); the others did not reach significant results. There was no improvement after 18 months in low-PTH patients. In radius, bone loss was not found.

Conclusion: A relationship between differences in progression of BMD after transplantation and PTH level at baseline was found.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Bone Density*
  • Bone Diseases, Metabolic / diagnosis
  • Bone Diseases, Metabolic / etiology*
  • Cohort Studies
  • Female
  • Humans
  • Kidney Transplantation / adverse effects*
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Parathyroid Hormone / blood*
  • Prospective Studies
  • Time Factors

Substances

  • PTH protein, human
  • Parathyroid Hormone