title: Zoledronic acid to prevent bone loss in the first 6 months after renal transplantation.
abstract: BACKGROUND
  Bisphosphonates can prevent bone mineral density loss after renal transplantation, but their effect on trabecular mineralization and bone morphology, two key factors of bone stability, remains unknown.
  
  
  METHODS
  In a 6-month, randomized, placebo-controlled study, 20 kidney transplant recipients received either 4 mg zoledronic acid or placebo twice within 3 months after engraftment. At transplantation and after 6 months, mean trabecular calcium concentration and trabecular morphometry were measured in bone biopsies. Bone mineral density (BMD) of the femoral neck and the lumbar spine were evaluated by dual-energy x-ray absorptiometry, and serum biochemical markers of bone metabolism were determined monthly.
  
  
  RESULTS
  Trabecular calcium content increased significantly in the zoledronic acid group, but remained unchanged in the placebo group. BMD at femoral neck showed no change in the zoledronic acid group, but decreased in the placebo group. BMD of the lumbar spine was increased in the zoledronic acid group without change in the placebo group. High-turnover bone disease resolved similarly in both groups, as evidenced by a significant decrease of eroded bone surface, osteoclast and osteoblast surface. Serologic markers of bone formation and resorption were significantly lower in zoledronic acid-treated patients throughout the study. Kidney transplant function was stable after zoledronic acid therapy.
  
  
  CONCLUSIONS
  Our results show that administration of zoledronic acid improves the calcium content of cancellous bone after kidney transplantation. The beneficial effect of bisphosphonate therapy is further evidenced by an increase of lumbar spine BMD, and stabilization of femur BMD.
authors.affiliation: Department of Internal Medicine III, University Vienna, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Haas
authors.forename: Zdenka
authors.initials: Z
authors.lastname: Leko-Mohr
authors.forename: Paul
authors.initials: P
authors.lastname: Roschger
authors.forename: Josef
authors.initials: J
authors.lastname: Kletzmayr
authors.forename: Christoph
authors.initials: C
authors.lastname: Schwarz
authors.forename: Christa
authors.initials: C
authors.lastname: Mitterbauer
authors.forename: Rudolf
authors.initials: R
authors.lastname: Steininger
authors.forename: Stefan
authors.initials: S
authors.lastname: Grampp
authors.forename: Klaus
authors.initials: K
authors.lastname: Klaushofer
authors.forename: Günter
authors.initials: G
authors.lastname: Delling
authors.forename: Rainer
authors.initials: R
authors.lastname: Oberbauer
mesh_terms: D015415:Biomarkers; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000378:metabolism; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000188:drug therapy* / Q000517:prevention & control*; D004164:Diphosphonates / Q000627:therapeutic use*; D005260:Female; D005272:Femur Neck / Q000378:metabolism; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008159:Lumbar Vertebrae / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control; D000077211:Zoledronic Acid
chemical_list: D015415:Biomarkers; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D002118:Calcium