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10.1681/ASN.2013080851 http://scihub22266oqcxt.onion/10.1681/ASN.2013080851 C4033378!4033378 !24511131     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=24511131 &cmd=llinks): Failed to open stream: HTTP request failed! 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Kidney transplantation with early corticosteroid withdrawal: paradoxical effects at the central and peripheral skeleton |pdf=|usr=}}{{24511131 }} gab.com Text Kidney transplantation with early corticosteroid withdrawal: paradoxical effects at the central and peripheral skeleton JO: J Am Soc Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=24511131 #FOAvip The use of early corticosteroid withdrawal (ECSW) protocols after kidney transplantation has become common, but the effects on fracture risk and bone quality are unclear. We enrolled 47 first-time adult transplant recipients managed with ECSW into a 1-year study to evaluate changes in bone mass, microarchitecture, biomechanical competence, and remodeling with dual energy x-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HRpQCT), parathyroid hormone (PTH) levels, and bone turnover markers obtained at baseline and 3, 6, and 12 months post-transplantation. Compared with baseline, 12-month areal bone mineral density by DXA did not change significantly at the spine and hip, but it declined significantly at the 1/3 and ultradistal radii (2.2% and 2.9%, respectively; both P<0.001). HRpQCT of the distal radius revealed declines in cortical area, density, and thickness (3.9%, 2.1%, and 3.1%, respectively; all P<0.001), trabecular density (4.4%; P<0.001), and stiffness and failure load (3.1% and 3.5%, respectively; both P<0.05). Findings were similar at the tibia. Increasing severity of hyperparathyroidism was associated with increased cortical losses. However, loss of trabecular bone and bone strength were most severe at the lowest and highest PTH levels. In summary, ECSW was associated with preservation of bone mineral density at the central skeleton; however, it was also associated with progressive declines in cortical and trabecular bone density at the peripheral skeleton. Cortical decreases related directly to PTH levels, whereas the relationship between PTH and trabecular bone decreases was bimodal. Studies are needed to determine whether pharmacologic agents that suppress PTH will prevent cortical and trabecular losses and post-transplant fractures. Twit Text FOAVip Kidney transplantation with early corticosteroid withdrawal: paradoxical effects at the central and peripheral skeleton ????J Am Soc Nephrol http://www.kidney.de/pget.php?&tw=1&pmid=24511131 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=24511131 #FOAvip English Wikipedia <ref>{{Cite pmid|24511131 }}</ref> Kidney transplantation with early corticosteroid withdrawal: paradoxical effects at the central and peripheral skeleton #MMPMID24511131 Iyer SP ; Nikkel LE ; Nishiyama KK ; Dworakowski E ; Cremers S ; Zhang C ; McMahon DJ ; Boutroy S ; Liu XS ; Ratner LE ; Cohen DJ ; Guo XE ; Shane E ; Nickolas TL J Am Soc Nephrol 2014[Jun]; 25 (6 ): 1331-41 PMID24511131 show ga The use of early corticosteroid withdrawal (ECSW) protocols after kidney transplantation has become common, but the effects on fracture risk and bone quality are unclear. We enrolled 47 first-time adult transplant recipients managed with ECSW into a 1-year study to evaluate changes in bone mass, microarchitecture, biomechanical competence, and remodeling with dual energy x-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HRpQCT), parathyroid hormone (PTH) levels, and bone turnover markers obtained at baseline and 3, 6, and 12 months post-transplantation. Compared with baseline, 12-month areal bone mineral density by DXA did not change significantly at the spine and hip, but it declined significantly at the 1/3 and ultradistal radii (2.2% and 2.9%, respectively; both P<0.001). HRpQCT of the distal radius revealed declines in cortical area, density, and thickness (3.9%, 2.1%, and 3.1%, respectively; all P<0.001), trabecular density (4.4%; P<0.001), and stiffness and failure load (3.1% and 3.5%, respectively; both P<0.05). Findings were similar at the tibia. Increasing severity of hyperparathyroidism was associated with increased cortical losses. However, loss of trabecular bone and bone strength were most severe at the lowest and highest PTH levels. In summary, ECSW was associated with preservation of bone mineral density at the central skeleton; however, it was also associated with progressive declines in cortical and trabecular bone density at the peripheral skeleton. Cortical decreases related directly to PTH levels, whereas the relationship between PTH and trabecular bone decreases was bimodal. Studies are needed to determine whether pharmacologic agents that suppress PTH will prevent cortical and trabecular losses and post-transplant fractures. |Adult [MESH] |Bone Density/drug effects [MESH] |Bone Diseases/*chemically induced/diagnostic imaging/epidemiology [MESH] |Bone Remodeling/drug effects [MESH] |Dexamethasone/administration & dosage/*adverse effects [MESH] |Female [MESH] |Follow-Up Studies [MESH] |Glucocorticoids/administration & dosage/adverse effects [MESH] |Graft Rejection/*drug therapy [MESH] |Hip Fractures/*chemically induced/diagnostic imaging/epidemiology [MESH] |Humans [MESH] |Kidney Failure, Chronic/epidemiology/*surgery [MESH] |Kidney Transplantation/*adverse effects/statistics & numerical data [MESH] |Longitudinal Studies [MESH] |Male [MESH] |Middle Aged [MESH] |Radiography [MESH] |Risk Factors [MESH]Kidney transplantation with early corticosteroid withdrawal: paradoxic(epmc).pdf DeepDyve Pubget Overpricing