Early bone mineral density loss after renal transplantation and pre-transplant PTH: a prospective study.
BACKGROUND
Post-transplant osteopathy is a known complication of kidney transplantation (KTx). The aim of this study was to assess bone mineral density (BMD) in a large cohort of patients with treatment depending on pre-transplant parathormone (PTH) and baseline BMD.


METHODS
347 consecutive KTx recipients (222 M, 125 F) finished all follow-up measurements of BMD at lumbar spine, femur and radius using DEXA Lunar (at baseline and at 6 and 18 months).


RESULTS
Bone loss with a T-score below -2.5 affected 37.2% of patients before KTx. A negative correlation between baseline PTH and BMD was found (p < 0.01). Patients with high levels of PTH had more bone loss than patients with low PTH values (p < 0.01). In the lumbar spine, a decline of BMD was found in the first 6 months, and after 18 months an improvement was found in all subgroups (p < 0.001). In femur, significant changes were found only in low-PTH patients after 6 months (p < 0.001); the others did not reach significant results. There was no improvement after 18 months in low-PTH patients. In radius, bone loss was not found.


CONCLUSIONS
A relationship between differences in progression of BMD after transplantation and PTH level at baseline was found.
Department of Nephrology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic. petr.bubenicek@medicon.cz
Petr
P
Bubenicek
Ivo
I
Sotornik
Stefan
S
Vitko
Vladimir
V
Teplan
D000328:Adult; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D011446:Prospective Studies; D013997:Time Factors
C470125:PTH protein, human; D010281:Parathyroid Hormone