Bone and mineral disorders after kidney transplantation: therapeutic strategies.
Mineral and bone diseases (MBD) are common in patients with chronic kidney disease who undergo kidney transplantation. The incidence, types and severity of MBD vary according to the duration of chronic kidney disease, presence of comorbid conditions and intake of certain medications. Moreover, multiple types of pathology may be responsible for MBD. After successful reversal of uremia by kidney transplantation, many bone and mineral disorders improve, while immunosuppression, other medications, and new and existing comorbidities may result in new or worsening MBD. Chronic kidney disease is also common after kidney transplantation and may impact bone and mineral disease. In this article, we reviewed the prevalence, pathophysiology, and impact of MBD on post-transplant outcomes. We also discussed the diagnostic approach; immunosuppression management and potential treatment of MBD in kidney transplant recipients.
Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA; Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Miklos Z
MZ
Molnar
Department of Medicine, Division of Nephrology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Mohamed S
MS
Naser
Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA.
Connie M
CM
Rhee
Division of Nephrology and Hypertension, University of California Irvine Medical Center, Orange, CA, USA; Departments of Community Health Sciences and Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
Kamyar
K
Kalantar-Zadeh
David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. Electronic address: bunnapradist@mednet.ucla.edu.
Suphamai
S
Bunnapradist
D015502:Absorptiometry, Photon / Q000379:methods; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D015995:Prevalence; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000601:surgery*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome