title: Hyperparathyroidism and vitamin D deficiency predispose to bone loss in renal transplant recipients.
abstract: BACKGROUND
  Bone disease is common postrenal transplantation resulting in increased fracture rates and morbidity. The cause is multifactorial including hyperparathyroidism, corticosteroids, and possibly calcium and vitamin D deficiencies. The aim of this study was to identify modifiable factors contributing to bone disease in long-term renal transplant (RT) recipients.
  
  
  METHODS
  Ninety-seven RT recipients were prospectively recruited over a 6-month period from a single center. Bone-related parameters were collected including bone mineral density at lumbar spine and total hip sites, serum and urinary markers of bone-turnover and calcium metabolism, and intact parathyroid hormone levels.
  
  
  RESULTS
  The mean time posttransplant of RT recipients was 9.5 years and mean estimated glomerular filtration rate was 70.3 mL/min. Up to 50% of recipients had biochemical evidence of calcium and vitamin D deficiencies. In the multiple regression models, elevated intact parathyroid hormone levels and calcium deficiency, which are affected by estimated glomerular filtration rate and vitamin D levels, are significantly associated with reduction in bone mineral density measurements.
  
  
  CONCLUSIONS
  Hyperparathyroidism and vitamin D deficiency are common and are likely to contribute to bone loss postrenal transplantation. Measures aim to correct these problems pre- and posttransplant may improve bone health in RT recipients.
authors.affiliation: Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Wai H
authors.initials: WH
authors.lastname: Lim
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Coates
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Russ
authors.forename: Patrick Toby H
authors.initials: PT
authors.lastname: Coates
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D015519:Bone Density; D002118:Calcium / Q000378:metabolism; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications*; D016030:Kidney Transplantation / Q000379:methods*; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D011446:Prospective Studies; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000150:complications*
chemical_list: D000305:Adrenal Cortex Hormones; D010281:Parathyroid Hormone; D002118:Calcium