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Is renal osteodystrophy reversible?

S Madsen, J H Thaysen, K Olgaard

    Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
    |January 1, 1977
    PubMed
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    Kidney transplant recipients showed improved bone health markers, suggesting renal osteodystrophy reversal. However, reduced bone mineral content persisted, indicating potential long-term skeletal issues after transplantation.

    Area of Science:

    • Nephrology
    • Endocrinology
    • Orthopedics

    Background:

    • Renal osteodystrophy is a common complication in patients with chronic kidney disease.
    • Successful kidney transplantation can improve many complications of kidney disease.

    Purpose of the Study:

    • To investigate the potential reversibility of renal osteodystrophy after kidney transplantation.
    • To assess bone health markers in kidney transplant recipients after prednisone withdrawal.

    Main Methods:

    • Studied 11 kidney transplant recipients 1.5 years after prednisone withdrawal.
    • Assessed serum levels of ionized calcium, phosphorus, alkaline phosphatases, and parathyroid hormone (PTH).
    • Utilized skeletal radiography, Technetium polyphosphate (Tc-PP) bone scintigraphy, and radial bone mineral content (BMC) measurements.

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    Main Results:

    • Nine out of eleven (82%) patients exhibited normal blood biochemistry, radiography, and Tc-PP scintigraphy.
    • This contrasts with the high frequency of abnormalities typically seen in hemodialysis patients.
    • Radial bone mineral content (BMC) was significantly reduced by 13.5%, similar to levels found in hemodialysis patients.

    Conclusions:

    • Successful kidney transplantation may lead to partial regression of renal osteodystrophy.
    • Persistent decreased mineralization of the appendicular skeleton was observed.
    • The cause of persistent low BMC (long-term steroid use or irreversible component) remains undetermined.