Bone mineral density, bone turnover markers, and incident fractures in de novo kidney transplant recipients

[en] Kidney transplant recipients are at increased risk of fractures. This prospective observational study investigated whether areal bone mineral density (aBMD) as assessed by dual-energy x-ray absorptiometry can predict incident fragility fractures in de novo kidney transplant recipients and whether bone turnover markers increase diagnostic accuracy. Parameters of bone mineral metabolism including parathyroid hormone (PTH), fibroblast growth factor 23, sclerostin, calcidiol and calcitriol, and bone turnover markers were assessed in blood samples collected immediately prior to kidney transplantation in 518 adult recipients. aBMD was measured at several skeletal sites within 14 days posttransplant. Thirty patients had a history of a fragility fracture at the time of transplantation, and osteopenia or osteoporosis at the femoral neck was observed in 77%. Bone turnover markers were inversely correlated with aBMD at all skeletal sites. Low aBMD and low PTH were associated with history of fragility fracture at the time of transplantation, independent of age, gender, and comorbidity. During a median post-transplant follow-up of 5.2 years, 38 patients sustained a fragility fracture, corresponding to a fracture incidence of 14.1 per 1000 person-years. Low aBMD at the hip and lumbar spine were associated with incident fractures, independent of classical determinants, including history of fracture. PTH and bone turnover markers at the time of transplantation failed to predict incident fractures. In conclusion, aBMD is low, correlates inversely with bone turnover, and predicts incident fractures in de novo kidney transplant recipients. © 2019 International Society of Nephrology

Disciplines :

Laboratory medicine & medical technology

Author, co-author :

Evenepoel, Pieter; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Claes, Kathleen J.; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Meijers, Björn K.I.; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Laurent, Michaël R.; Centre for Metabolic Bone Diseases, Leuven, Belgium

Bammens, Bert R.M.; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Naesens, M.; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Sprangers, Ben; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Pottel, Hans; Department of Public Health and Primary Care, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium

Cavalier, Etienne ; Université de Liège - ULiège > Département de pharmacie > Chimie médicale

Kuypers, Dirk R.J.; Department of Nephrology and Renal Transplantation, University Hospitals Leuven and Laboratory of Nephrology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium

Language :

English

Title :

Bone mineral density, bone turnover markers, and incident fractures in de novo kidney transplant recipients

Publication date :

2019

Journal title :

Kidney International

ISSN :

0085-2538

eISSN :

1523-1755

Publisher :

Elsevier B.V.

Volume :

Issue :

Pages :

1461-1470

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 14 February 2020

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51 (3 by ULiège)

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4 (3 by ULiège)

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