Bone disease in renal transplantation and pleotropic effects of vitamin D therapy.
Osteoporosis, osteopenia, and osteonecrosis are common in renal transplant recipients. In this study, we evaluated relationship between bone mineral density (BMD) and posttransplant duration; creatinine clearance; serum levels of glucose, calcium, phosphorus, alkaline phosphatase, vitamin D (vitD), parathormone, magnesium, C telopeptide, osteocalcin, lipids, and vit D therapy. Eighty five subjects included in this study had a mean age of 36.25 ± 10.5 years. At least at 6-month intervals we measured femoral neck (FN) and lumbar vertebra (LV) by DEXA and biochemical parameters. VitD was prescribed in 57 patients (vitDG). The mean duration of posttransplantation follow-up was 9.82 ± 2.72 months. T scores (TS) of FN and LV were normal in 29.4% and 21.2%; osteopenia in 56.5% and 49.4%; and osteoporosis in 12.1% and 29.4% of patients, respectively. Upon follow-up, TS improved significantly from -1.58 to -1.46 in FN and from -1.88 to -1.70 in LV (P < .05 for both). In patients receiving vitDG, TS improved significantly from -1.74 to -1.61 on FN and from -2.16 to -1.97 on LV (P < .05 for both). Osteocalcin and vitDG levels decreased in all patients (P < .05 for all). Blood urea nitrogen and serum creatinine increased (P < .05). In VitDG cohort, triglyceride levels decreased (P < .05) with unchanged blood glucose values; but among the other patients, triglycerides were unchanged but glucose levels had increased (P < .05). Bone disease including osteopenia or osteoporosis was observed among 70%. During the follow-up period, BMD increased significantly from baseline at 9.82 ± 2.72 months. VitD therapy caused more prominent improvements in BMD and decreases in serum triglycerides as well as mutigated the increase in blood glucose.
Sikgenc
M M
MM
Department of Nephrology, Cukurova University, Adana, Turkey.
Paydas
S
S
Balal
M
M
Demir
E
E
Kurt
C
C
Sertdemir
Y
Y
Binokay
F
F
Erken
U
U
D001379:Azathioprine / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001847:Bone Diseases / Q000453:epidemiology*; D001851:Bone Diseases, Metabolic / Q000453:epidemiology; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D010020:Osteonecrosis / Q000453:epidemiology; D010024:Osteoporosis / Q000453:epidemiology; D020123:Sirolimus / Q000627:therapeutic use; D014807:Vitamin D / Q000627:therapeutic use*
D008055:Lipids; D014807:Vitamin D; D003404:Creatinine; D009173:Mycophenolic Acid; D001379:Azathioprine; D020123:Sirolimus; D008775:Methylprednisolone