Abstract | BACKGROUND: In type 1 diabetic patients with end-stage renal failure, low bone mass is prevalent and the incidence of fractures high after simultaneous pancreas kidney transplantation (SPK). Data are scarce on preexisting skeletal morbidity or the long-term effects of SPK on bone mass and risk of fractures. METHODS: We conducted a prospective study addressing these issues in 19 consecutive SPK recipients before and at 3, 6, and 12 months, and 2.5 to 4 years after establishment of graft function. RESULTS: Prior to transplantation, 13 patients (68%) had hyperparathyroidism, 7 of whom had osteoporosis. Mean bone mineral density (BMD) was significantly lower at the femoral neck than at the lumbar spine (T-scores -2.0 +/- 0.89 vs. -0.66 +/- 0.84). There was a significant decrease in BMD at both lumbar spine and femoral neck at 6 months post- transplantation (-6.0 +/- 5.4% and -6.9 +/- 4.3%, respectively). No further loss was observed in the following 6 months. At 1 year post- transplantation, 9 patients had osteoporosis associated with hyperparathyroidism in 8, and none had sustained a clinical fracture. A significant albeit small increase in BMD was observed 6 months after start of alfacalcidol 0.25 microg/day. At end-evaluation, osteoporosis and hyperparathyroidism persisted in the patients in whom it was documented at 1 year. Five patients who had lower BMD at the femoral neck pretransplantation sustained a clinical fracture. CONCLUSION:
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Authors | Yves F C Smets, Johan W de Fijter, Jan Ringers, Herman H P J Lemkes, Neveen A T Hamdy |
Journal | Kidney international
(Kidney Int)
Vol. 66
Issue 5
Pg. 2070-6
(Nov 2004)
ISSN: 0085-2538 [Print] United States |
PMID | 15496181
(Publication Type: Journal Article)
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Chemical References |
- Hydroxycholecalciferols
- alfacalcidol
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Topics |
- Bone Density
(drug effects)
- Diabetes Mellitus, Type 1
(complications)
- Diabetic Nephropathies
(etiology, metabolism)
- Follow-Up Studies
- Fractures, Bone
(epidemiology, etiology)
- Humans
- Hydroxycholecalciferols
(therapeutic use)
- Hyperparathyroidism
(complications, drug therapy)
- Incidence
- Kidney Failure, Chronic
(complications, etiology, metabolism, surgery)
- Kidney Transplantation
(adverse effects)
- Osteoporosis
(complications)
- Pancreas Transplantation
(adverse effects)
- Prospective Studies
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