Mineral and bone disorder after kidney transplantation

Core Tip

Core tip: Despite the improvement in mineral metabolites and mineral regulating hormones after kidney transplantation, abnormal mineral metabolism continues to present in most patients. High dose corticosteroid and persistent hyperparathyroidism are the most important factors influencing abnormal mineral metabolism in long-term kidney transplant recipients. The use of active vitamin D with or without bisphosphonate and steroid withdrawal regimen are effective in preventing early post-transplant bone loss. Calcimimetic is an alternative therapy to parathyroidectomy. If parathyroidectomy is required, subtotal to near total parathyroidectomy is recommended. Performing parathyroidectomy during the waiting period is also preferred in patients with severe hyperparathyroidism associated with hypercalcemia.