Impact of parathyroid hormone on bone density in long-term renal transplant patients with good graft function

Transplantation. 2006 Sep 27;82(6):749-52. doi: 10.1097/


Background: It remains unknown whether low-grade hyperparathyroidism persisting beyond the first year postrenal transplantation has any impact on bone density.

Methods: Parathyroid hormone (PTH), glomerular filtration rate (GFR), and bone density (by dual-energy x-ray absorptiometry [DXA]) were monitored in the follow-up of our transplant patients. Of 260 long-term renal transplant patients, 41 fulfilled the following criteria: Two DXA measurements performed at least five years apart (median 6.8 years, range 5-9); GFR>or=35 ml/min per 1.73 m body surface area (median 50, range 35-76); no bisphosphonate treatment or parathyroidectomy in the study period.

Results: In all, 40% had mean PTH values above the normal limit 6.9 pmol/L (65 pg/ml), and the range was 0.9-17 pmol/L. In the first DXA, 8 of 41 patients had osteoporosis and 17 more had osteopenia. Hip bone density Z-score was -0.60 SD, range (-2.6 to +2.3). The absolute median value (g/cm) remained unchanged until the second DXA, but among patients there was a variation which ranged from -2.3% to +1.7% per year. In a simple linear regression analysis, these changes were significantly correlated to mean PTH (r=0.16, P=0.010). Median lumbar spine bone density was also reduced in the first DXA and was not different at follow-up, but with this variable individual changes did not correlate to mean PTH.

Conclusion: Bone density is often reduced and PTH remains elevated in long-term renal transplant patients with good transplant function. Slight to moderate elevation of PTH is associated with reduction in hip bone mineral density.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Bone Density*
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hyperthyroidism / epidemiology
  • Hyperthyroidism / physiopathology*
  • Kidney Transplantation / physiology*
  • Middle Aged
  • Parathyroid Hormone / blood*
  • Regression Analysis
  • Time Factors


  • Parathyroid Hormone