Early bone mineral density loss after renal transplantation and pre-transplant PTH: a prospective study

Post-transplant osteopathy is a known complication of kidney transplantation (KTx). The aim of this study was to assess bone mineral density (BMD) in a large cohort of patients with treatment depending on pre-transplant parathormone (PTH) and baseline BMD.

347 consecutive KTx recipients (222 M, 125 F) finished all follow-up measurements of BMD at lumbar spine, femur and radius using DEXA Lunar (at baseline and at 6 and 18 months).

Bone loss with a T-score below -2.5 affected 37.2% of patients before KTx. A negative correlation between baseline PTH and BMD was found (p < 0.01). Patients with high levels of PTH had more bone loss than patients with low PTH values (p < 0.01). In the lumbar spine, a decline of BMD was found in the first 6 months, and after 18 months an improvement was found in all subgroups (p < 0.001). In femur, significant changes were found only in low-PTH patients after 6 months (p < 0.001); the others did not reach significant results. There was no improvement after 18 months in low-PTH patients. In radius, bone loss was not found.

A relationship between differences in progression of BMD after transplantation and PTH level at baseline was found.