Impact of bisphosphonate treatment on bone mineral density after kidney transplant

doi:10.5500/wjt.v14.i3.92335

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World Journal of Transplantation

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2220-3230

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Transplant. Sep 18, 2024; 14(3): 92335
Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.92335

Impact of bisphosphonate treatment on bone mineral density after kidney transplant

Georgia Andriana Georgopoulou, Marios Papasotiriou, Theodoros Ntrinias, Eirini Savvidaki, Dimitrios S Goumenos, Evangelos Papachristou

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.

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.

Keywords: Mineral and bone disorders; Chronic kidney disease; Kidney transplant recipients; Bisphosphonates; Bone mineral density

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.