Georgopoulou GA, Papasotiriou M, Ntrinias T, Savvidaki E, Goumenos DS, Papachristou E. Impact of bisphosphonate treatment on bone mineral density after kidney transplant. World J Transplant 2024; 14(3): 92335 [DOI: 10.5500/wjt.v14.i3.92335]
Corresponding Author of This Article
Marios Papasotiriou, MD, PhD, Assistant Professor, Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patras 26504, Greece. mpapasotiriou@yahoo.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Georgia Andriana Georgopoulou, Marios Papasotiriou, Theodoros Ntrinias, Eirini Savvidaki, Dimitrios S Goumenos, Evangelos Papachristou, Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patras 26504, Greece
Author contributions: Papachristou E, Goumenos DS and Papasotiriou M designed the overall concept and outlined the manuscript; Georgopoulou GA and Ntrinias T contributed to the discussion and design of the manuscript; Papasotiriou M and Georgopoulou GA contributed to the writing and editing of the manuscript and illustrations; Savvidaki E contributed to the literature review; and all authors have read and approved the final manuscript.
Institutional review board statement: This retrospective cohort study was approved by the hospital’s Ethics Committee and was performed in accordance with the 1975 Helsinki Declaration.
Informed consent statement: All study participants, or their legal authorized representative, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: The technical appendix, statistical code, and datasets are available from the corresponding author at mpapasotiriou@yahoo.com and mpapasotir@upatras.gr.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marios Papasotiriou, MD, PhD, Assistant Professor, Department of Nephrology and Kidney Transplantation, University Hospital of Patras, Patras 26504, Greece. mpapasotiriou@yahoo.com
Received: January 22, 2024 Revised: March 4, 2024 Accepted: July 2, 2024 Published online: September 18, 2024 Processing time: 190 Days and 9 Hours
Abstract
BACKGROUND
Mineral bone disease is associated with chronic kidney disease and persists after kidney transplantation. Immunosuppressive treatment contributes to the pathogenesis of this disease. Bisphosphonate treatments have shown positive but indefinite results.
AIM
To evaluate the effectiveness and safety of bisphosphonate treatment on post kidney transplantation bone mineral density (BMD).
METHODS
We included kidney transplant recipients (KTRs) whose BMD was measured after the operation but before the initiation of treatment and their BMD was measured at least one year later. We also evaluated the BMD of KTRs using two valid measurements after transplantation who received no treatment (control group).
RESULTS
Out of 254 KTRs, 62 (39 men) were included in the study. Bisphosphonates were initiated in 35 KTRs in total (20 men), 1.1 ± 2.4 years after operation and for a period of 3.9 ± 2.3 years while 27 (19 men) received no treatment. BMD improved significantly in KTRs who received bisphosphonate treatments (from -2.29 ± 1.07 to -1.66 ± 1.09, P < 0.0001). The control group showed a non-significant decrease in BMD after 4.2 ± 1.4 years of follow-up after surgery. Kidney function was not affected by bisphosphonate treatment. In KTRs with established osteoporosis, active treatment had a similar and significant effect on those with osteopenia or normal bone mass.
CONCLUSION
In this retrospective study of KTRs receiving bisphosphonate treatment, we showed that active treatment is effective in preventing bone loss irrespective of baseline BMD.
Core Tip: Mineral bone disease can occur in patients with chronic kidney disease and is highly prevalent among patients after kidney transplantation. In this study, antiresorptive treatment with bisphosphonates had a beneficial effect on bone mineral density (BMD) in kidney transplant recipients (KTRs) irrespective of baseline BMD values. KTRs who received no treatment showed a non-significant decrease in BMD.
