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2010 ; 6
(1
): 32-40
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Bone disease after renal transplantation
#MMPMID19918255
Malluche HH
; Monier-Faugere MC
; Herberth J
Nat Rev Nephrol
2010[Jan]; 6
(1
): 32-40
PMID19918255
show ga
In light of greatly improved long-term patient and graft survival after renal
transplantation, improving other clinical outcomes such as risk of fracture and
cardiovascular disease is of paramount importance. After renal transplantation, a
large percentage of patients lose bone. This loss of bone results from a
combination of factors that include pre-existing renal osteodystrophy,
immunosuppressive therapy, and the effects of chronically reduced renal function
after transplantation. In addition to low bone volume, histological abnormalities
include decreased bone turnover and defective mineralization. Low bone volume and
low bone turnover were recently shown to be associated with cardiovascular
calcifications, highlighting specific challenges for medical therapy and the need
to prevent low bone turnover in the pretransplant patient. This Review discusses
changes in bone histology and mineral metabolism that are associated with renal
transplantation and the effects of these changes on clinical outcomes such as
fractures and cardiovascular calcifications. Therapeutic modalities are evaluated
based on our understanding of bone histology.
|*Kidney Transplantation
[MESH]
|Animals
[MESH]
|Chronic Kidney Disease-Mineral and Bone Disorder/epidemiology/*physiopathology
[MESH]