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Management of Bone Loss After Organ Transplantation
Author(s) -
Cohen Adi,
Sambrook Philip,
Shane Elizabeth
Publication year - 2004
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.040912
Subject(s) - medicine , osteoporosis , bone remodeling , bone resorption , transplantation , kidney transplantation , metabolic bone disease , bone disease , organ transplantation , vitamin d and neurology , surgery
Organ transplant recipients experience rapid bone loss and high fracture rates, particularly during the early post‐transplant period. Early rapid bone loss occurs in the setting of uncoupled bone turnover with increased bone resorption and decreased bone formation. Because there are no clinical factors that reliably predict post‐transplant bone loss and fractures in the individual patient, all transplant recipients should be considered candidates for early preventive therapy for osteoporosis. Long‐term transplant recipients with densitometric osteoporosis and/or fractures should also receive treatment. Although active metabolites of vitamin D and bisphosphonates have both shown efficacy, data from clinical trials suggest that bisphosphonates are the safest and most consistently effective agents for the prevention and treatment of post‐transplantation osteoporosis in adults. Kidney transplant recipients represent a special population, and more research is needed to delineate the risks and benefits of treating bone disease in these patients.