Zoledronic acid to prevent bone loss in the first 6 months after renal transplantation

Zoledronic acid to prevent bone loss in the first 6 months after renal transplantation. Bisphosphonates can prevent bone mineral density loss after renal transplantation, but their effect on trabecular mineralization and bone morphology, two key factors of bone stability, remains unknown. In a 6-mon...

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Bibliographic Details
Published in:Kidney international 2003-03, Vol.63 (3), p.1130-1136
Main Authors: Haas, Martin, Leko-Mohr, Zdenka, Roschger, Paul, Kletzmayr, Josef, Schwarz, Christoph, Mitterbauer, Christa, Steininger, Rudolf, Grampp, Stefan, Klaushofer, Klaus, Delling, Günter, Oberbauer, Rainer
Format: Article
Language:English
Subjects:
Biological and medical sciences
Biomarkers
biopsy
Bone Density - drug effects
bone mineralization
Calcium - metabolism
Chronic Kidney Disease-Mineral and Bone Disorder - drug therapy
Chronic Kidney Disease-Mineral and Bone Disorder - prevention & control
Diphosphonates - therapeutic use
Female
Femur Neck - metabolism
Humans
Imidazoles - therapeutic use
Kidney Transplantation
Lumbar Vertebrae - metabolism
Male
Medical sciences
Middle Aged
morphometry
Postoperative Complications - drug therapy
Postoperative Complications - prevention & control
renal transplantation
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
zoledronic acid
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Summary:Zoledronic acid to prevent bone loss in the first 6 months after renal transplantation. Bisphosphonates can prevent bone mineral density loss after renal transplantation, but their effect on trabecular mineralization and bone morphology, two key factors of bone stability, remains unknown. In a 6-month, randomized, placebo-controlled study, 20 kidney transplant recipients received either 4 mg zoledronic acid or placebo twice within 3 months after engraftment. At transplantation and after 6 months, mean trabecular calcium concentration and trabecular morphometry were measured in bone biopsies. Bone mineral density (BMD) of the femoral neck and the lumbar spine were evaluated by dual-energy x-ray absorptiometry, and serum biochemical markers of bone metabolism were determined monthly. Trabecular calcium content increased significantly in the zoledronic acid group, but remained unchanged in the placebo group. BMD at femoral neck showed no change in the zoledronic acid group, but decreased in the placebo group. BMD of the lumbar spine was increased in the zoledronic acid group without change in the placebo group. High-turnover bone disease resolved similarly in both groups, as evidenced by a significant decrease of eroded bone surface, osteoclast and osteoblast surface. Serologic markers of bone formation and resorption were significantly lower in zoledronic acid-treated patients throughout the study. Kidney transplant function was stable after zoledronic acid therapy. Our results show that administration of zoledronic acid improves the calcium content of cancellous bone after kidney transplantation. The beneficial effect of bisphosphonate therapy is further evidenced by an increase of lumbar spine BMD, and stabilization of femur BMD.
ISSN:0085-2538
1523-1755
DOI:10.1046/j.1523-1755.2003.00816.x