Bone histomorphometry in de novo renal transplant recipients indicates a further decline in bone resorption 1 year posttransplantation

Kidney Int. 2017 Feb;91(2):469-476. doi: 10.1016/j.kint.2016.10.008. Epub 2016 Dec 18.

Abstract

Renal transplantation is believed to have a major impact on bone health. The present prospective observational bone biopsy study aimed to define the natural history of bone histomorphometry parameters in contemporaneous de novo renal transplant recipients. Paired bone biopsies were performed at the time of transplantation and at one-year posttransplantation in an unselected cohort of 36 patients referred for deceased kidney replacement. Parameters of mineral metabolism and circulating bone turnover markers were monitored as well. Static parameters of bone formation and especially bone resorption being already low-normal in the majority of patients at the time of renal transplantation, further declined during the first posttransplant year. However, interindividual variation was substantial, and significance was reached only for bone resorption parameters. Bone mineralization and trabecular bone volume were within the normal range at the time of transplantation (83.3% and 91.7% of graft recipients, respectively) and showed little change one-year posttransplantation. Changes in osteoclast number were paralleled by changes in circulating tartrate-resistant acid phosphatase 5b levels. Finally, cumulative glucocorticoid dose, but not the posttransplantation parathyroid hormone level, associated with trabecular bone loss. Thus, the impact of renal transplantation on bone histomorphometry is limited with only bone resorption, being already low at the time of transplantation, showing a further decline.

Keywords: bone; histomorphometry; renal transplantation.

Publication types

  • Observational Study

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Biomarkers / blood
  • Biopsy
  • Bone Density
  • Bone Remodeling*
  • Bone Resorption / blood
  • Bone Resorption / diagnosis
  • Bone Resorption / etiology*
  • Bone Resorption / physiopathology
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / metabolism
  • Bone and Bones / pathology
  • Bone and Bones / physiopathology*
  • Dose-Response Relationship, Drug
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / adverse effects
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Osteoclasts / metabolism
  • Osteoclasts / pathology
  • Prospective Studies
  • Risk Factors
  • Tartrate-Resistant Acid Phosphatase / blood
  • Time Factors
  • Treatment Outcome

Substances

  • Biomarkers
  • Glucocorticoids
  • Immunosuppressive Agents
  • ACP5 protein, human
  • Tartrate-Resistant Acid Phosphatase