A prospective randomized study for prevention of postrenal transplantation bone loss.
BACKGROUND
We aimed to investigate different treatment drugs for the prevention of post-transplant bone loss.


METHODS
Sixty adult male recent renal transplant recipients were enrolled into the study. Patients were randomized into 4 groups: group I received daily alfacalcidol 0.5 microg PO; group II received oral alendronate 5 mg/day; group III received intranasal salmon calcitonin 200 IU every other day; and group IV was considered a control group. Every patient was supplemented with daily 500 mg oral calcium carbonate. Parameters of bone metabolism were measured before and at 12 months after starting treatment. Bone mineral density (BMD) was measured by (DEXA) at lumber spine, femoral neck, and forearm before and after treatment period.


RESULTS
BMD was increased at lumber spine by 2.1%, 0.8%, 1.7%, by 1.8%, 0.6%, 1.6% at femoral neck, and by 3.2%, 1.9%, 2.6% at forearm in groups I, II, and III, respectively, while it decreased by 3.2%, 3.8%, and 1.8% at the same sites, respectively, in control group (P= <0.05). iPTH level decreased significantly in group I, while the decrease was insignificant in other groups (P= 0.003). All other parameters were not statistically significant between treatment groups. Apart from transient hypocalcaemia in 3 patients in group II, and 2 patients in group III, no other significant adverse effects were noted.


CONCLUSIONS
This study proves that early bone loss that occurs during the first 12 months after renal transplantation could be prevented by alfacalcidol, calcitonin, or alendronate. Among the treatment groups, alfacalcidol significantly improved the hyperparathyroidism. All treatment drugs are safe and tolerable.
El-Agroudy
Amgad E
AE
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. amgadelbaz@ahram0505.net
El-Husseini
Amr A
AA
El-Sayed
Moharam
M
Mohsen
Tarek
T
Ghoneim
Mohamed A
MA
D000328:Adult; D019386:Alendronate / Q000008:administration & dosage; D015519:Bone Density / Q000187:drug effects; D002116:Calcitonin / Q000008:administration & dosage; D002119:Calcium Carbonate / Q000008:administration & dosage; D006801:Humans; D006887:Hydroxycholecalciferols / Q000008:administration & dosage; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000502:physiology; D008297:Male; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D016037:Single-Blind Method
D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; C028815:salmon calcitonin; D002116:Calcitonin; D002119:Calcium Carbonate; C008088:alfacalcidol; D019386:Alendronate