Determinants of short-term changes in body composition following renal transplantation

Dolgos, Szilveszter; Hartmann, Anders; Jenssen, Trond; Isaksen, Gunhild Aker; Pfeffer, Per; Bollerslev, Jens

doi:10.1080/00365590802273226

Cited by 23 publications

(11 citation statements)

References 29 publications

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“…It appears that this change in bone formation markers occurs already within 10 weeks following initiation of therapy and continues to decline throughout the study period for ibandronate. Our findings are consistent with previous work from our group in that serum osteocalcin levels normally increase during the first 10 weeks after transplantation in patients not receiving bisphosphonates, calcium, or calcitriol (27).…”

Section: Discussionsupporting

confidence: 93%

A 1-Year Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Ibandronate on Bone Loss Following Renal Transplantation

Smerud

Dolgos

Olsen

et al. 2012

American Journal of Transplantation

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The clinical profile of ibandronate as add-on to calcitriol and calcium was studied in this double-blind, placebo-controlled trial of 129 renal transplant recipients with early stable renal function (≤ 28 days posttransplantation, GFR ≥ 30 mL/min). Patients were randomized to receive i.v. ibandronate 3 mg or i.v. placebo every 3 months for 12 months on top of oral calcitriol 0.25 mcg/day and calcium 500 mg b.i.d. At baseline, 10 weeks and 12 months bone mineral density (BMD) and biochemical markers of bone turnover were measured. The primary endpoint, relative change in BMD for the lumbar spine from baseline to 12 months was not different, +1.5% for ibandronate versus +0.5% for placebo (p = 0.28). Ibandronate demonstrated a significant improvement of BMD in total femur, +1.3% versus −0.5% (p = 0.01) and in the ultradistal radius, +0.6% versus −1.9% (p = 0.039). Bone formation markers were reduced by ibandronate, whereas the bone resorption marker, NTX, was reduced in both groups. Calcium and calcitriol supplementation alone showed an excellent efficacy and safety profile, virtually maintaining BMD without any loss over 12 months after renal transplantation, whereas adding ibandronate significantly improved BMD in total femur and ultradistal radius, and also suppressed biomarkers of bone turnover. Ibandronate was also well tolerated.

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Section: Discussionsupporting

confidence: 93%

A 1-Year Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Ibandronate on Bone Loss Following Renal Transplantation

Smerud

Dolgos

Olsen

et al. 2012

American Journal of Transplantation

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“…Total body fat (25), abdominal circumference, and BMI may increase after transplantation, which might be associated with increased risk for new-onset OSA. Mallamaci et al (13) reported the association between respiratory disturbance index and BMI in Tx patients, which is in accordance with our findings.…”

Section: Discussionmentioning

confidence: 99%

Sleep Apnea Is Associated with Cardiovascular Risk Factors among Kidney Transplant Patients

Molnar¹,

Lázár²,

Lindner³

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives:We assessed the prevalence of obstructive sleep apnea (OSA) and its clinical correlates in a large sample of patients who received a kidney transplant (Tx). We also compared the prevalence of the disorder between dialysis patients who were on the waiting list for a Tx (WL) and Tx patients. Conclusions: The prevalence of OSA is similar in Tx and WL patients and it may contribute to presence of hypertension in patients who receive a Tx.

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“…As with previous studies, the eGFR measures all overestimated the measured GFR and bias did not differ between patients on long‐term steroids or not. However, there was a significant drop in precision in those patients receiving long‐term maintenance steroids, which may relate to an increase in body fat to muscle ratio in patients receiving long‐term steroids . Another factor that may affect the reliability of creatinine‐based equations in transplant recipients is the use of co‐trimoxazole as prophylaxis against Pneumocystis jiroveci pneumonia, which has been shown to reduce the renal excretion of creatinine and elevate the serum creatinine level in transplant recipients …”

Section: Discussionmentioning

confidence: 99%

Variability in the reporting of renal function endpoints in immunosuppression trials in renal transplantation: time for consensus?

Knight

Hussain

2016

Clinical Transplantation

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Early measures of graft function are increasingly used to assess efficacy in clinical trials of kidney transplant immunosuppression. This study aimed to assess the variability and quality of reporting of these endpoints in contemporary trials. Data regarding renal function endpoints were extracted from 213 reports from randomized controlled trials comparing immunosuppressive interventions in renal transplant recipients published between 2010 and 2014. A total of 174 (81.7%) reports included a measure of renal function; in 44 (20.7%), this was the primary endpoint. A total of 103 manuscripts (48.4%) reported serum creatinine, 142 (66.6%) reported estimated glomerular filtration rate (eGFR), and 26 (12.2%) reported measured GFR. Formulas used for GFR estimation were modification of diet in renal disease (42.3%), Cockroft-Gault (23.5%), Nankivell (15.0%), and CKD-EPI (0.9%). Six studies (2.8%) did not report the formula used to estimate GFR. A total of 13.9% of endpoints had missing data. In 10 studies, disagreement was found in the significance of findings using different measures of renal function. There is a great deal of variability in the reporting of renal function endpoints, with a significant proportion of studies using underperforming or inappropriate estimates. There is a need for consensus as to the best tool for monitoring and reporting renal function post-transplant, and in particular for use in clinical trials and registries.

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Determinants of short-term changes in body composition following renal transplantation

Cited by 23 publications

References 29 publications

A 1-Year Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Ibandronate on Bone Loss Following Renal Transplantation

A 1-Year Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Ibandronate on Bone Loss Following Renal Transplantation

Sleep Apnea Is Associated with Cardiovascular Risk Factors among Kidney Transplant Patients

Variability in the reporting of renal function endpoints in immunosuppression trials in renal transplantation: time for consensus?

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