Reference : Natural history of mineral metabolism, bone turnover and bone mineral density in de n...
Scientific journals : Article
Human health sciences : Urology & nephrology
Human health sciences : Laboratory medicine & medical technology
http://hdl.handle.net/2268/232153
Natural history of mineral metabolism, bone turnover and bone mineral density in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol.
English
Evenepoel, Pieter [> >]
Claes, Kathleen [> >]
Meijers, Bjorn [> >]
Laurent, Michael R. [> >]
Bammens, Bert [> >]
Naesens, Maarten [> >]
Sprangers, Ben [> >]
Cavalier, Etienne mailto [Université de Liège - ULiège > Département de pharmacie > Chimie médicale >]
Kuypers, Dirk [> >]
In press
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Yes (verified by ORBi)
International
0931-0509
1460-2385
United Kingdom
[en] The skeletal effects of renal transplantation are not completely understood, especially in patients managed with a steroid minimization immunosuppressive protocol and long term. We enrolled 69 adult transplant recipients (39 males; ages 51.1 +/- 12.2 years), free of antiresorptive therapy and managed with a steroid minimization immunosuppressive protocol, into a 5-year prospective observational study to evaluate changes in areal bone mineral density (aBMD), mineral metabolism and bone remodelling. Dual energy X-ray absorptiometry, laboratory parameters of mineral metabolism (including parathyroid hormone, sclerostin and fibroblast growth factor 23) and non-renal cleared bone turnover markers (BTMs) (bone-specific alkaline phosphatase, trimeric N-terminal propeptide and tartrate-resistant acid phosphatase 5b) were assessed at baseline and 1 and 5 years post-transplantation. The mean cumulative methylprednisolone exposure at 1 and 5 years amounted to 2.5 +/- 0.8 and 5.8 +/- 3.3 g, respectively. Overall, bone remodelling activity decreased after transplantation. Post-transplant aBMD changes were minimal and were significant only in the ultradistal radius during the first post-operative year {median -2.2% [interquartile range (IQR) -5.9-1.2] decline, P = 0.01} and in the lumbar spine between Years 1 and 5 [median 1.6% (IQR -3.2-7.0) increase, P = 0.009]. BTMs, as opposed to mineral metabolism parameters and cumulative corticosteroid exposure, associated with aBMD changes, both in the early and late post-transplant period. Most notably, aBMD changes inversely associated with bone remodelling changes. In summary, in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol, BMD changes are limited, highly variable and related to remodelling activity rather than corticosteroid exposure.
http://hdl.handle.net/2268/232153
10.1093/ndt/gfy306

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