A prospective randomized study for the treatment of bone loss with vitamin d during kidney transplantation in children and adolescents.
The effect of treatment with alfacalcidol on post-transplantation bone loss in children and adolescents was investigated. Of the 63 young patients who received renal transplant and were subjected to dual-energy x-ray absorptiometry (DEXA), 30 patients had low-bone mineral density (BMD) (z-score < or = -1) and were enrolled into the study. Their mean age at the time of transplantation was 14.5 +/- 4.0 years and the mean duration after transplantation was 48 +/- 34 months. Patients with low BMD were randomized into two equal homogeneous groups: group 1 (control) received placebo and group 2 received daily alfacalcidol 0.25 microg by mouth. Parameters of bone metabolism (intact parathyroid hormone, serum osteocalcin and urinary deoxypyridinoline) and BMD were assessed before and after the study period. After 12 months of treatment BMD at the lumber spine decreased from -2.2 to -2.5 in group 1 while it increased from -2.1 to -0.6 in group 2 (p < 0.001). Serum intact parathyroid hormone level decreased significantly in group 2 (p = 0.042). Apart from transient hypercalcemia in 1 patient in group 2, no other significant adverse effects were noted. This study suggested the value of alfacalcidol in the treatment of bone loss in young renal transplant recipients.
El-Husseini
Amr A
AA
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. amr_2002_2002@yahoo.com
El-Agroudy
Amgad E
AE
El-Sayed
Moharam
M
Sobh
Mohamed A
MA
Ghoneim
Mohamed A
MA
D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D001847:Bone Diseases / Q000209:etiology* / Q000517:prevention & control*; D002648:Child; D005260:Female; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000145:classification / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male
D006887:Hydroxycholecalciferols; C008088:alfacalcidol