Interventions for preventing bone disease in kidney transplant recipients

Palmer, Suetonia C.; Chung, Edmund Y. M.; McGregor, David; Bachmann, Friederike; Strippoli, Giovanni F.M.

doi:10.1002/14651858.cd005015.pub4

Cited by 20 publications

(18 citation statements)

References 159 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, patients who have a creatinine clearance of <35 mL/minute should not use bisphosphonates as they are cleared by the kidney [8,11,43]. Yet, the consequence of bisphosphonate treatment on BMD is undetermined [44]. However, studies have shown that risedronate significantly elevates BMD and reduces vertebral fractures in osteoporotic women without causing any adverse effect on renal function [45].…”

Section: Managementmentioning

confidence: 99%

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Tasnim¹,

Dutta

Nayeem

et al. 2021

Cureus

View full text Add to dashboard Cite

Nowadays, chronic kidney disease (CKD) and osteoporosis have become crucial health-related issues globally. CKD-induced osteoporosis is a systemic disease characterized by the disruption of mineral, hormone, and vitamin homeostasis that elevates the likelihood of fracture. Here, we review recent studies on the association of CKD and osteoporosis. In particular, we focus on the pathogenesis of CKD-associated osteoporosis, including the homeostasis and pathways of several components such as parathyroid hormone, calcium, phosphate, vitamin D, fibroblast growth factor, and klotho, as well as abnormal bone mineralization, remodeling, and turnover. In addition, we explore the diagnostic tools and possible therapeutic approaches for the management and prevention of CKD-associated osteoporosis. Patients with CKD show higher osteoporosis prevalence, greater fracture rate, increased morbidity and mortality, and an elevated occurrence of hip fracture. We also rule out that increased severity of CKD is related to a more severe condition of osteoporosis. Furthermore, supplements such as calcium and vitamin D as well as lifestyle modifications such as exercise and cessation of smoking and alcohol help in fracture prevention. However, new approaches and advancements in treatment are needed to reduce the fracture risk in patients with CKD. Therefore, further collaborative multidisciplinary research is needed in this regard.

show abstract

Section: Managementmentioning

confidence: 99%

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Tasnim¹,

Dutta

Nayeem

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…It remained uncertain whether, apart from bisphosphonates, any other class of drugs reduced the fracture incidence. In the absence of trial data, the effect of PTX on fracture risk also could not be adequately assessed [13].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Parathyroidectomy on Osteoporotic Fractures in Kidney Transplant Recipients: Results from a Retrospective Single-Center Trial

Jehn

Kortenhorn

Schütte‐Nütgen

et al. 2022

JCM

View full text Add to dashboard Cite

Kidney transplant (KTx) recipients are a high-risk population for osteoporotic fractures. We herein aim to identify the role of pre-transplant parathyroidectomy (PTX) and other modifiable factors associated with osteoporotic fractures in KTx recipients. We conducted a retrospective study involving 711 adult patients (4608 patient-years) who were transplanted at our center between January 2007 and June 2015. Clinical data were extracted from patients’ electronic medical records. Different laboratory and clinical parameters for mineral bone disease (MBD) and osteoporosis, including medication, were evaluated. We chose fracture events unrelated to malignancies or adequate trauma as the primary endpoint. Osteoporotic fractures occurred in 47 (6.6%) patients (median 36.7 months, IQR 45.9) after KTx (fracture incidence of 10 per 1000 person-years). Prior to KTx, subtotal PTX was performed in 116 patients (16.3%, median time 4.2 years before KTx, IQR 5.0). Of the patients with fracture (n = 47), only one (2.2%) patient had previously undergone PTX. After adjusting for the known fracture risk factors MBD and osteoporosis, PTX remained a protective factor against fractures (HR 0.134, CI 0.018–0.991, p = 0.049). We observed a reduced risk for pathological fractures in KTx patients who underwent PTX, independent from elevated parathyroid hormone at the time of KTx or afterwards.

show abstract

“…Chronic kidney disease (CKD) is associated with mineral bone disease (CKD-MBD), a grouping of conditions including varying degrees of osteodystrophy, osteomalacia, adynamic bone, and abnormal bone mineralization (31,32). While several metabolic disorders improve after renal transplantation, bone damage persists and may even worsen (33).…”

Section: Discussionmentioning

confidence: 99%

Urinary collagen-derived peptides as sensitive markers for bone resorption and bisphosphonate treatment in kidney transplant patients

Marx

Anglicheau

Caillard

et al. 2022

Preprint

View full text Add to dashboard Cite

Kidney transplant recipients (KTR) are at increased risk of fractures. Total urinary hydroxyproline excretion used to be a marker for bone resorption (BR) but faded into the background when more specific markers like Beta-CrossLaps (CTX) became available. Proteomic studies identified numerous hydroxyproline-containing urinary collagen peptides but their origin remains unknown. We followed the hypothesis that some of the urinary collagen peptides are associated with BR and are markers for pathophysiological changes in bone metabolism of KTR. Clinical and laboratory data including serum levels of CTX in 96 KTR from two French centers (Strasbourg, n=38; Paris-Necker, n=58) were correlated with the signal intensity of urinary peptides identified by capillary electrophoresis (CE) coupled to mass spectrometry (MS) and tandem-MS. The effect of oral bisphosphonates on urinary peptides was studied in an independent group of 11 KTR. Eighty-two urinary peptides were identified to be significantly correlated with serum CTX levels in both cohorts. Statistical association with parameters other than BR markers were not significant. Collagen α-1(I) chain (COL1A1) was the most frequently identified peptide source. COL1A1 peptides associated with BR were significantly more hydroxylated than those showing no association (55.9% versus 45,2%, p<0.0003 by a χ2-test). From the 82 urinary peptides correlated to CTX, 17 were significantly associated with bisphosphonate treatment. All of these 17 peptides showed a marked reduction in their excretion levels after 410 ± 344 days of bisphosphonate treatment compared to baseline levels. We studied the cleavage sites of these COL1A1 peptides and observed a signature of Cathepsin K and Matrix Metallopeptidase 9. This study provides strong evidence for the occurrence of collagen peptides in the urine of KTR that are associated with BR and that are sensitive to bisphosphonate treatment. Their assessment might become a valuable tool to monitor bone status in KTR.

show abstract

Interventions for preventing bone disease in kidney transplant recipients

Cited by 20 publications

References 159 publications

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

Osteoporosis, an Inevitable Circumstance of Chronic Kidney Disease: A Systematic Review

The Influence of Parathyroidectomy on Osteoporotic Fractures in Kidney Transplant Recipients: Results from a Retrospective Single-Center Trial

Urinary collagen-derived peptides as sensitive markers for bone resorption and bisphosphonate treatment in kidney transplant patients

Contact Info

Product

Resources

About