Abnormal bone and mineral metabolism in kidney transplant patients--a review.
OBJECTIVE
Abnormal bone and mineral metabolism is common in patients with kidney failure and often persists after successful kidney transplant.


METHODS
To better understand the natural history of this disease in transplant patients, we reviewed the literature by searching MEDLINE for English language articles published between January 1990 and October 2006 that contained Medical Subject Headings and key words related to secondary or persistent hyperparathyroidism and kidney transplant.


RESULTS
Parathyroid hormone levels decreased significantly during the first 3 months after transplant but typically stabilized at elevated values after 1 year. Calcium tended to increase after transplant and then stabilize at the higher end of the normal range within 2 months. Phosphorus decreased rapidly to within or below normal levels after surgery and hypophosphatemia, if present, resolved within 2 months. Low levels of 1,25(OH)2 vitamin D typically did not reach normal values until almost 18 months after transplant.


CONCLUSIONS
This review provides evidence demonstrating that abnormal bone and mineral metabolism exists in patients after kidney transplant and suggests the need for treatment of this condition. However, better observational and interventional research is needed before advocating such a treatment guideline.
Sprague
Stuart M
SM
Evanston Northwestern Healthcare, Northwestern University Feinberg School of Medicine, Evanston, Ill. 60201, USA. ssprague@northwestern.edu
Belozeroff
Vasily
V
Danese
Mark D
MD
Martin
Lynn P
LP
Olgaard
Klaus
K
D015415:Biomarkers / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism* / Q000473:pathology; D002118:Calcium / Q000097:blood; D018450:Disease Progression; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis* / Q000209:etiology*; D007668:Kidney / Q000378:metabolism; D007674:Kidney Diseases / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D010758:Phosphorus / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D014807:Vitamin D / Q000097:blood
D015415:Biomarkers; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium