title: Effect of ibandronate on bone loss and renal function after kidney transplantation.
abstract: Severe osteoporosis frequently is observed after organ transplantation. In kidney transplantation, it adds to pre-existing renal bone disease and strategies to prevent osteoporosis are not established. Eighty kidney recipients were included in a randomized controlled prospective intervention trial. Treated patients (n = 40) received an injection of ibandronate, a bisphosphonate, immediately before and at 3, 6, and 9 mo after transplantation. The primary outcome measured was the change in bone mineral density. Secondary measures included graft outcome, spinal deformities, fracture rate, body height, and hormonal and metabolic data. Loss of spongy and cortical bone after transplantation was prevented by ibandronate. Changes of bone mineral density (ibandronate versus controls) were as follows: lumbar spine, -0.9 +/- 6.1% versus -6.5 +/- 5.4% (P < 0.0001); femoral neck, +0.5 +/- 5.2% versus -7.7 +/- 6.5% (P < 0.0001); and midfemoral shaft, +2.7 +/- 12.2% versus -4.0 +/- 10.9% (P = 0.024). Fewer spinal deformities developed with ibandronate (7 patients with 7 deformities versus 12 patients with 23 deformities; P = 0.047). Loss of body height was 0.5 +/- 1.0 cm versus 1.1 +/- 1.0 cm in control subjects (P = 0.040). Two bone fractures occurred in each group. There were fewer acute rejection episodes with ibandronate (11 versus 22; P = 0.009). Graft function after 1 yr was comparable. Bone loss, spinal deformation, and loss of body height during the first year after kidney transplantation are prevented by injection of ibandronate at intervals of 3 mo. The smaller number of rejection episodes of the ibandronate-treated group should be confirmed and its mechanism should be explored in additional studies.
authors: Department of Internal Medicine, Division of Nephrology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Wolfgang
authors: W
authors: Grotz
authors: Department of Internal Medicine, Division of Nephrology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Christian
authors: C
authors: Nagel
authors: Department of Internal Medicine, Division of Nephrology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Daria
authors: D
authors: Poeschel
authors: Department of Internal Medicine, Division of Nephrology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Markus
authors: M
authors: Cybulla
authors: Department of Internal Medicine, Division of Endocrinology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Karl-Georg
authors: KG
authors: Petersen
authors: Department of Diagnostic Radiology, Division of Transplantation, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Markus
authors: M
authors: Uhl
authors: Department of Surgery, Division of Transplantation, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Christoph
authors: C
authors: Strey
authors: Department of Surgery, Division of Transplantation, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Günter
authors: G
authors: Kirste
authors: Department of Medical Biometrics, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Manfred
authors: M
authors: Olschewski
authors: Department of Orthopedics, Division of Transplantation, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Achim
authors: A
authors: Reichelt
authors: Department of Internal Medicine, Division of Nephrology, University Hospital, Albert-Ludwigs-University, Freiburg, Germany.
authors: Lars Christian
authors: LC
authors: Rump
mesh_terms: D000328:Adult; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D000077557:Ibandronic Acid; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000517:prevention & control*; D013122:Spinal Diseases / Q000517:prevention & control; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D004164:Diphosphonates; D000077557:Ibandronic Acid