Sprague SM, Belozeroff V, Danese MD, Martin LP, Olgaard K. Abnormal bone and mineral metabolism in kidney transplant patients--a review.
Am J Nephrol 2007;
28:246-53. [PMID:
17989497 DOI:
10.1159/000110875]
[Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 09/10/2007] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS
Abnormal bone and mineral metabolism is common in patients with kidney failure and often persists after successful kidney transplant.
METHODS
To better understand the natural history of this disease in transplant patients, we reviewed the literature by searching MEDLINE for English language articles published between January 1990 and October 2006 that contained Medical Subject Headings and key words related to secondary or persistent hyperparathyroidism and kidney transplant.
RESULTS
Parathyroid hormone levels decreased significantly during the first 3 months after transplant but typically stabilized at elevated values after 1 year. Calcium tended to increase after transplant and then stabilize at the higher end of the normal range within 2 months. Phosphorus decreased rapidly to within or below normal levels after surgery and hypophosphatemia, if present, resolved within 2 months. Low levels of 1,25(OH)2 vitamin D typically did not reach normal values until almost 18 months after transplant.
CONCLUSION
This review provides evidence demonstrating that abnormal bone and mineral metabolism exists in patients after kidney transplant and suggests the need for treatment of this condition. However, better observational and interventional research is needed before advocating such a treatment guideline.
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