Bisphosphonates are effective prophylactic of early bone loss after renal transplantation.
BACKGROUND
Rapid bone loss and fractures occur early after solid organ transplantation. We examined the preliminary results of a prospective study evaluating the efficacy of prophylactic use of bisphosphonates in renal allograft recipients.


METHODS
Bone mineral density (BMD) was measured at the lumbar spine and the hip by dual energy X-ray absorptiometry at 1, 6, 12 months. Alendronian or risedronian were initiated for patients with osteopenia or osteoporosis at 1 month who had no contraindications to bisphosphonates. The treatment lasted at least 6 months. Sixty-six patients were included in the study; 39 were treated with bisphosphonates (A), and 27 were drug-free (B). Presently, 24 group A and 13 group B patients have completed the 12-month observation period.


RESULTS
In group A 53.8% (21) subjects had osteoporosis and 46.2% (18), osteopenia. Mean T-score L(2)-L(4) in group A at 1, 6, and 12 months were: (-)2.22 +/- 1.06; (-)2.07 +/- 1.25; (-)1.89 +/- 1.07, respectively. The T-score increase between 6 and 12 months was significant (P = 0.0014). The relative rise in BMD L(2)-L(4) between 1 and 12 months was 2.26%. In group B mean T-score L(2)-L(4) at 1, 6, and 12 months were: (-)0.26 +/- 1.34; (-)0.80 +/- 1.19; (-)1.2 +/- 1.59, respectively. The T-score decrease between 1 and 12 months in group B was significant (P = .0082). The 12-month relative decrease in femoral neck and trochanter BMD in group B was (-)2.1% and (-)2.75%, respectively.


CONCLUSIONS
Bisphosphonates are effective for prophylaxis of rapid bone loss early after renal transplantation.
Nowacka-Cieciura
E
E
Department of Transplant Medicine and Nephrology, Medical University of Warsaw, ul. Nowogrodzka 59, 02-006 Warsaw, Poland. ewnowacka@wp.pl
Cieciura
T
T
Baczkowska
T
T
Kozińska-Przybył
O
O
Tronina
O
O
Chudziński
W
W
Pacholczyk
M
M
Durlik
M
M
D015502:Absorptiometry, Photon; D019386:Alendronate / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001851:Bone Diseases, Metabolic / Q000188:drug therapy*; D001862:Bone Resorption / Q000517:prevention & control*; D012968:Etidronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D063065:Organophosphonates / Q000627:therapeutic use*; D010024:Osteoporosis / Q000188:drug therapy*; D011183:Postoperative Complications / Q000188:drug therapy / Q000517:prevention & control*; D000068296:Risedronic Acid
D050071:Bone Density Conservation Agents; D063065:Organophosphonates; D000068296:Risedronic Acid; D012968:Etidronic Acid; D019386:Alendronate