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Treatment of Osteoporosis and Osteopenia in Long‐term Renal Transplant Patients with Alendronate
Author(s) -
Cruz Din.,
Brickel Helen M.,
Wysolmerski John J.,
Gundberg Caren G.,
Simpson Christine A.,
Kliger Alan S.,
Lorber Marc I.,
Basadonna Giacomo P.,
Friedman Amy L.,
Insogna Karl L.,
Bia Margaret J.
Publication year - 2002
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1034/j.1600-6143.2002.020111.x
Subject(s) - medicine , deoxypyridinoline , bone remodeling , osteopenia , pyridinoline , osteoporosis , bone mineral , urology , bone resorption , osteocalcin , bisphosphonate , renal function , endocrinology , alkaline phosphatase , enzyme , biochemistry , chemistry
Bone mineral density (BMD) and biochemical markers of bone‐turnover were evaluated in a 2‐year study in 58 long‐term renal transplant recipients with good renal function. In the first year of study, data were collected and patients with osteoporosis and parameters of high bone turnover were classified as being at high risk for on‐going bone loss (Group A; n = 29). Patients with lesser degrees of bone loss or without biochemical parameters of high bone turnover were followed longitudinally (Group B; n = 29). Group A patients were then placed on alendronate 10 mg/day and both groups were followed for an additional year. Changes in regional BMD and bone‐turnover markers between the first and second year within each group were analyzed using paired tests. BMD in Group A, which had declined at the lumbar spine (− 1.6 ± 0.5%) and total femur (− 1.5 ± 0.4%) during the first year of the study, increased on alendronate therapy at both the lumbar spine (+ 3.4 ± 0.6%, p = 0.001) and total femur (+ 1.6 ± 0.6%, p < 0.001). These patients also experienced a significant decline in levels of serum alkaline phosphatase, osteocalcin, urinary levels of deoxypyridinoline and pyridinoline. In contrast, neither BMD nor biochemical markers changed significantly over 2 years in Group B. The current results demonstrate that renal transplant patients with osteoporosis and biochemical parameters of high bone turnover are at continued risk for bone loss. Therapy with a bisphosphonate can reverse this bone loss and even increase bone mass in these patients. Whether patients with lesser degrees of bone loss and/or patients without parameters of high bone turnover can also benefit from bisphosphonate therapy deserves further study.