Progression of Osteoporosis After Kidney Transplantation in Patients With End-Stage Renal Disease

Transplant Proc. 2017 Jun;49(5):1033-1037. doi: 10.1016/j.transproceed.2017.03.038.

Abstract

Background: This study investigated the prevalence of osteoporosis and the risk factors for its progression in kidney transplant recipients (KTRs).

Methods: Dual energy X-ray absorptiometry was used to prospectively measure changes in bone mineral density (BMD) before kidney transplantation (KT) and 1 year after transplantation in 207 individuals. We also analyzed the risk factors of osteoporosis progression during this period.

Results: Prior to KT, the mean BMD score (T-score of the femur neck area) was -2.1 ± 1.2, and the prevalence of osteoporosis was 41.5% (86/207). At 1 year post-transplantation, the mean BMD score significantly decreased to -2.3 ± 1.1 (P < .001), and the prevalence of osteoporosis increased to 47.3% (98/207; P = .277). The BMD score worsened over the study period in 69.1% (143/207) of patients, improved in 24.1% (50/207), and showed no change in 6.8% (14/207). Minimal intact parathyroid hormone (iPTH) improvement after KT was found to be an independent risk factor of osteoporosis progression.

Conclusions: This study demonstrates progressive loss of BMD after KT and sustained secondary hyperparathyroidism might influence the progression of osteoporosis.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Bone Density
  • Disease Progression*
  • Female
  • Femur Neck
  • Humans
  • Hyperparathyroidism, Secondary / etiology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / epidemiology*
  • Osteoporosis / etiology
  • Parathyroid Hormone / blood
  • Postoperative Complications*
  • Postoperative Period
  • Prevalence
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors

Substances

  • Parathyroid Hormone