Alendronate for treatment of renal transplant patients with osteoporosis.
Osteoporosis is a frequent complication after renal transplantation. Some workers have shown that bisphosphonates may be effective to prevent and treat corticosteroid-induced osteoporosis in these patients. In this study we report our experience with administration of the biphosphonate alendronate to treat renal transplanted patients with established osteoporosis.


METHODS
Twelve to 24 months after transplantation (9 women, 5 men) 14 renal transplant patient were treated with alendronate and 12 patients (7 women, 5 men) were untreated. All patients displayed an iPTH <240 pg/mL and a bone mineral density (BMD) t-score <-2.5. All patients received cyclosporine and prednisone therapy. Biochemical measurements, BMD, and X-rays of the lumbar spine were measured during study. Patients in the treatment group received alendronate 10 mg/d (po) and vitamin D plus calcium (800 UI cholecalciferol and 2.5 g of CaCO(3)) per day while those in the control group only received vitamin D plus calcium, at the same dose.


RESULTS
There was no difference in mean age, weight, time after transplantation, or immunosuppression between the treatment and control groups. There were no significant differences in the biochemical parameters during the study period. Over the 1-year study period, patients receiving alendronate displayed a greater increase in BMD. Lumbar spine BMD increased 4.3 +/- 6.1% in the treatment group versus 0.55 +/- 5.30% in controls. Femoral neck BMD increased 10.3 +/- 11.9% and 2.2 +/- 5.7%, respectively, in the treatment and control groups. Patients receiving alendronate frequently experienced intestinal disconfort.


CONCLUSIONS
The bisphosphonate alendronate is effective to treat renal transplant patients suffering from established osteporosis.
Torregrosa
J V
JV
Renal Transplant Unit, and Nuclear Medicine Department, Hospital Clinic, Barcelona, Spain. vtorre@clinic.ub.es
Moreno
A
A
Gutierrez
A
A
Vidal
S
S
Oppenheimer
F
F
D019386:Alendronate / Q000627:therapeutic use*; D015519:Bone Density; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy* / Q000209:etiology*; D010281:Parathyroid Hormone / Q000097:blood; D013997:Time Factors
D007166:Immunosuppressive Agents; D010281:Parathyroid Hormone; D019386:Alendronate