Changes in Bone Histomorphometry after Kidney Transplantation

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http://hdl.handle.net/10138/310945

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Keronen , S , Martola , L , Finne , P , Burton , I S , Kröger , H & Honkanen , E 2019 , ' Changes in Bone Histomorphometry after Kidney Transplantation ' , Clinical journal of the American Society of Nephrology , vol. 14 , no. 6 , pp. 894-903 . https://doi.org/10.2215/CJN.09950818

Title: Changes in Bone Histomorphometry after Kidney Transplantation
Author: Keronen, Satu; Martola, Leena; Finne, Patrik; Burton, Inari S.; Kröger, Heikki; Honkanen, Eero
Contributor: University of Helsinki, Nefrologian yksikkö
University of Helsinki, Department of Medicine
University of Helsinki, University Management
University of Helsinki, HUS Abdominal Center
Date: 2019-06-07
Language: eng
Number of pages: 10
Belongs to series: Clinical journal of the American Society of Nephrology
ISSN: 1555-9041
URI: http://hdl.handle.net/10138/310945
Abstract: Background and objectives Over the past decade, the management of CKD-mineral and bone disorder has changed substantially, altering the pattern of bone disease in CKD. We aimed to evaluate the natural history of kidney bone disease in contemporary kidney transplant recipients and patients on dialysis. Design, settings, participants, & measurements Sixty one patients on dialysis who were referred to kidney transplantation participated in this prospective cohort study during November 2009 and December 2010. We performedbaseline bone biopsieswhile thepatientswere ondialysis andrepeatedthe procedure in 56 patients at 2 years after kidney transplantation or 2 years after baseline if transplantationwas not performed. Measurements of mineral metabolism and bone turnover, as well as dual energy x-ray absorptiometry scans, were obtained concurrently. Results A total of 37 out of 56 participants received a kidney transplant, of which 27 underwent successful repeat bone biopsy. The proportion of patients with high bone turnover declined from 63% at baseline to 19% at 2 years after kidney transplantation, whereas the proportion of thosewith lowbone turnover increased from26% to 52%. Of 19 participants remaining on dialysis after 2 years, 13 underwent successful repeat biopsy. The proportion of patients remaining on dialysis with high bone turnover decreased from 69% to 31%, and low bone turnover increased from8% to 38%. Abnormal bonemineralization increased in transplant recipients from33% to 44%, but decreased in patients remaining on dialysis from 46% to 15%. Trabecular bone volume showed little change after transplantation, but low bone volume increased in patients remaining on dialysis. Bone mineral density did not correlate with histomorphometric findings. Conclusions Bone turnover decreased over time both in patients remaining on dialysis and in kidney transplant recipients. Bone mineral density and bone biomarkers were not associated with bone metabolism changes detected in bone biopsy specimens.
Subject: RENAL-TRANSPLANTATION
DISEASE
OSTEODYSTROPHY
TURNOVER
RISK
RECIPIENTS
DISORDERS
FRACTURES
EVOLUTION
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
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