Preventing bone loss in renal transplant recipients with vitamin D.
Very rapid bone loss, osteopenia, and osteoporosis have been documented in the first 6 to 12 mo after renal transplantation. Investigated was the effect of treatment with active vitamin D on the prevention of posttransplantation bone loss. Forty adult men who were recent renal transplant recipients were enrolled onto the study. Patients were randomized into two groups: group 1 received daily alfacalcidol 0.5 micro g by mouth, and group 2 (control) received placebo. Every patient in both groups received daily 500-mg calcium carbonate supplements. Parameters of bone metabolism and bone mineral density measured at three sites were assessed before and after the study period. Bone mineral density was increased by 2.1%, 1.8%, and 3.2% at lumbar spine, femoral neck, and forearm, respectively, in group 1, whereas it decreased by 3.2%, 3.8%, and 1.8% at the same sites in the control group (P < 0.05). Serum intact parathyroid hormone level decreased significantly in group 1 compared with the control group (P = 0.003). Early bone loss that occurs during the first 1 yr after renal transplantation could be prevented by alfacalcidol. Use of alfacalcidol early after transplantation is safe and well tolerated.
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. amgadelbaz@ahram0505.net
Amgad E
AE
El-Agroudy
Amr A
AA
El-Husseini
Moharam
M
El-Sayed
Mohamed A
MA
Ghoneim
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D006887:Hydroxycholecalciferols; C008088:alfacalcidol