Effects of Early Administration of Vitamin D or Alendronate on the Change of Bone Mineral Density after Renal Transplantation.
- Author:
Ki Hwan KWON
1
;
Myoung Soo KIM
;
Jai Hyun LIM
;
Kyu Ha HUH
;
Hyun Jung KIM
;
Hyung Joon AHN
;
Kyung Ock JEON
;
Bong Soo CHA
;
Soon Il KIM
;
Yu Seun KIM
Author Information
1. The Research Institute for Transplantation, Yonsei University College of Medicine, Korea.
- Publication Type:Original Article
- Keywords:
Renal transplantation;
Bone mineral density;
Vitamin D;
Alendronate
- MeSH:
Administration, Oral;
Alendronate*;
Bone Density*;
Femur;
Kidney Transplantation*;
Spine;
Transplantation;
Vitamin D*;
Vitamins*
- From:The Journal of the Korean Society for Transplantation
2005;19(1):27-35
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The decrease in bone mineral density (BMD) is a major complication after kidney transplantation. This was reported to occur preferentially during the first 6 months. However, the treatment and prevention strategies against a decline of BMD are not yet clear. METHODS: The data on the pre-transplant baseline and post-transplant 1 year BMD were archived and retrieved in 125 renal transplant recipients. The post-transplant changes of the BMD were compared by the baseline status of the BMD and the types of anti-osteoporosis treatment either with a vitamin D agent (alfacalcidiol) (n=18) or alendronate (n=21). Anti-osteoporosis treatment began within 30 days after transplantation, with an oral administration of 0.5 mcg/day vitamin D or 70 mg/week alendronate, and maintained until 1 year after transplantation. RESULTS: Regardless the degree of baseline BMD status, each group (the control, vitamin D, or alendronate group) showed a significant and uniform decrease of BMD during the post-transplant 1 year. The mean change in the spine BMD in the control, vitamin D, and alendronate group was -7.1+/-7.5%, -3.3+/-7.4% and -2.6+/-6.5%, respectively. The femur BMD also changed -5.1+/-7.7%, 1.1+/-5.3% and -1.5+/-8.2%, respectively. The degree of BMD decrease in the treatment groups was significantly lower than that in the control (P=0.014 in spine, P=0.003 in femur). When the severely reduced baseline BMD (T-score of spine or femur < or =-1) subgroups were analysed separately, the treatment groups (-3.7+/-6.5% in vitamin D and -1.1+/-6.4% in alendronate group) showed a significantly less decrease in the spine BMD than the control (-8.2+/-6.2%)(P=0.036). The femur BMD also showed a less decrease in the BMD in the treatment group, but this was not statistically significant (P=0.234). There was no significant difference between the vitamin D and alendronate treatment groups. CONCLUSION: After renal transplantation, early administration of vitamin D or alendronate showed some benefit to reduce the post-transplant decrease of BMD in both spine and femur area.
