Evolution of bone disease after kidney transplantation: A prospective histomorphometric analysis of trabecular and cortical bone

• Type: Article in International Scientific Journal
• Date: 2016

Authors

Carvalho, C (Author) Other; Magalhaes, J (Author) Other; Pereira, L (Author) Other; Simoes Silva, L (Author) Other; Castro Ferreira, I (Author) Other; João Frazão (Author) FMUP

Journal

Title: Nephrology

Vol. 21

Pages: 55-61

ISSN: 1320-5358

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 14 Citations

Scopus - 15 Citations

Other information

Authenticus ID: P-00K-2CT

DOI: 10.1111/nep.12570

Abstract (EN): Aim: Post-transplant bone disease results from multiple factors, including previous bone and mineral metabolism disturbances and effects from transplant-related medications. Bone biopsy remains the gold-standard diagnostic tool. Methods: We aimed to prospectively evaluate trabecular and cortical bone by histomorphometry after kidney transplantation. Seven patients, willing to perform follow-up bone biopsy, were included in the study. Dual-X-ray absorptiometry and trans-iliac bone biopsy were performed within the first 2 months after renal transplantation and repeated after 2-5 years of follow-up. Results: Follow-up biopsy revealed a significant decrease in osteoblast surface/bone surface (0.91 +/- 0.81 to 0.47 +/- 0.12%, P = 0.036), osteoblasts number/bone surface (0.45 (0.23, 0.94) to 0.00/mm(2), P = 0.018) and erosion surface/bone surface (3.75 +/- 2.02 to 2.22 +/- 1.38%, P = 0.044). A decrease in trabecular number (3.55 (1.81, 2.89) to 1.55/mm (1.24, 2.06), P = 0.018) and increase in trabecular separation (351.65 +/- 135.04 to 541.79 +/- 151.91 mu m, P = 0.024) in follow-up biopsy suggest loss in bone quantity. We found no significant differences in cortical analysis, except a reduction in external cortical osteonal eroded surface (5.76 (2.94, 13.97) to 3.29% (0.00, 6.67), P = 0.043). Correlations between bone histomorphometric and dual-X-ray absorptiometry parameters gave inconsistent results. Conclusions: The results show a reduction in bone activity, suggesting increased risk of adynamic bone and loss of bone volume. Cortical bone seems less affected by post-transplant biological changes in the first years after kidney transplantation.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7