Efficacy of low doses of pamidronate in osteopenic patients administered in the early post-renal transplant.

Abstract

UNLABELLED:

This study evaluates the efficacy of low doses of pamidronate after renal transplantation to prevent bone loss in osteopenic patients. Results show that pamidronate is safe and significantly reduced spinal bone loss when administered immediately after renal transplantation.

INTRODUCTION:

The purpose of this work is to evaluate the efficacy of two intravenous infusions of pamidronate in the immediate post-transplant period in a renal transplant (RT) population.

METHODS:

In this 12-month, randomized, double-blind, multicenter trial, 39 kidney recipients with diagnosed osteopenia received two doses of 30 mg of disodium pamidronate (n = 24) or placebo (n = 15), at surgery and 3 months post-RT. All patients received calcium and vitamin D. Bone density of the lumbar spine and total femur was measured by dual-energy X-ray absorptiometry (DXA) and X-rays were performed at RT, 6 and 12 months post-RT. Biochemical and hormonal determinations were performed before and after treatment.

RESULTS:

Pamidronate significantly reduced spinal bone loss, but no significant benefit was found for the incidence of fractures. Elevated baseline intact parathyroid hormone (iPTH) and bone remodeling markers returned to normal levels 3 months post-RT. However, normal procollagen type I N propeptide (PINP) concentrations were only maintained in the pamidronate group. After RT, a comparable graft function was observed in both groups according to creatinine values, 25-hydroxyvitamin-D (25-OH-D) levels were improved, and serum calcium levels normalized after a transient fall during the first 3 months.

CONCLUSION:

A low dose of pamidronate prevents bone loss in osteopenic patients when administered immediately after RT.

• Authors: J-V Torregrosa, D Fuster, A Monegal, M A Gentil, J Bravo, L Guirado, A Muxí, J Cubero
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 22 Issue 1 Pg. 281-7 (Jan 2011) ISSN: 1433-2965 [Electronic] England
• PMID: 20229199 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Density Conservation Agents
• Diphosphonates
• Creatinine
• Pamidronate

Topics

• Adult
• Aged
• Bone Density (drug effects)
• Bone Density Conservation Agents (administration & dosage, adverse effects, therapeutic use)
• Bone Diseases, Metabolic (drug therapy, etiology, physiopathology)
• Bone Remodeling (drug effects)
• Creatinine (blood)
• Diphosphonates (administration & dosage, adverse effects, therapeutic use)
• Epidemiologic Methods
• Female
• Femur (physiopathology)
• Femur Neck (physiopathology)
• Humans
• Infusions, Intravenous
• Kidney Transplantation (adverse effects)
• Lumbar Vertebrae (physiopathology)
• Male
• Middle Aged
• Osteoporotic Fractures (prevention & control)
• Pamidronate
• Postoperative Care (methods)
• Treatment Outcome