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Recent Changes in Chronic Kidney Disease-Mineral and Bone Disorders and Associated Fractures After Kidney Transplantation
- Source :
- Transplantation. 101(8)
- Publication Year :
- 2016
-
Abstract
- The management of chronic kidney disease-mineral and bone disorders has recently changed. We investigated the modifications of chronic kidney disease-mineral and bone disorder with a special focus on the incidence of fractures in the first year after kidney transplantation (KT).We retrospectively compared 2 groups of patients who consecutively underwent transplantation at our center 5 years from each other. Group 1 consisted of patients (n = 152) transplanted between 2004 and 2006, whereas patients in group 2 (n = 137) underwent KT between 2009 and 2011.During the end-stage renal disease phase at the time of transplant, cinacalcet, and native vitamin D were used significantly more frequently in group 2. Median intact parathyroid hormone levels were lower and severe hyperparathyroidism decreased significantly. Vitamin D deficiency dropped from 64% to 20%. After transplantation, persistent hyperparathyroidism (parathyroid hormone130 ng/L) and bone turnover markers were significantly reduced in group 2. Native vitamin D supplementation increased over time, whereas the use of active vitamin D was unchanged. The 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were significantly higher. The fracture incidence at 1 year decreased significantly (3.1% vs 9.1%; P = 0.047). No steroid sparing was observed in group 2. Bisphosphonates after KT were more frequently used in group 2.Recent changes in clinical practice are associated with reductions in pretransplant and posttransplant hyperparathyroidism, vitamin D deficiency, and fracture risk after KT.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
030232 urology & nephrology
Urology
030230 surgery
03 medical and health sciences
Fractures, Bone
Young Adult
0302 clinical medicine
medicine
Humans
Young adult
Vitamin D
Kidney transplantation
Aged
Retrospective Studies
Aged, 80 and over
Chronic Kidney Disease-Mineral and Bone Disorder
Transplantation
Kidney
Bone Density Conservation Agents
urogenital system
business.industry
Incidence (epidemiology)
Incidence
Follow up studies
Retrospective cohort study
Middle Aged
medicine.disease
Kidney Transplantation
Surgery
medicine.anatomical_structure
Female
France
business
Kidney disease
Follow-Up Studies
Subjects
Details
- ISSN :
- 15346080
- Volume :
- 101
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....46058b1e7e63a82cfbb9a4aba60707c5