Open AccessMetabolic bone diseases in kidney transplant recipients
Author(s) -
Rubin Zhang,
Kanwaljit K Chouhan
Publication year - 2012
Publication title -
world journal of nephrology
Language(s) - Uncategorized
Resource type - Journals
ISSN - 2220-6124
DOI - 10.5527/wjn.v1.i5.127
Subject(s) - medicine , renal osteodystrophy , metabolic bone disease , bone remodeling , osteoporosis , kidney disease , bone disease , transplantation , osteodystrophy , metabolic acidosis , hyperparathyroidism , vitamin d and neurology , hypophosphatemia , kidney transplantation , vitamin d deficiency , endocrinology
Metabolic bone disease after kidney transplantation has a complex pathophysiology and heterogeneous histology. Pre-existing renal osteodystrophy may not resolve completely, but continue or evolve into a different osteodystrophy. Rapid bone loss immediately after transplant can persist, at a lower rate, for years to come. These greatly increase the risk of bone fracture and vertebral collapse. Each patient may have multiple risk factors of bone loss, such as steroids usage, hypogonadism, persistent hyperparathyroidism (HPT), poor allograft function, metabolic acidosis, hypophosphatemia, vitamin D deficiency, aging, immobility and chronic disease. Clinical management requires a comprehensive approach to address the underlying and ongoing disease processes. Successful prevention of bone loss has been shown with vitamin D, bisphosphonates, calcitonin as well as treatment of hypogonadism and HPT. Novel approach to restore the normal bone remodeling and improve the bone quality may be needed in order to effectively decrease bone fracture rate in kidney transplant recipients.