Mineral Bone Disorders in Kidney Transplantation

Ayman Al Jurdi; Janaina Da Silva Martins; Leonardo V Riella

doi:10.1016/j.semnephrol.2021.03.011

Mineral Bone Disorders in Kidney Transplantation

Semin Nephrol. 2021 Mar;41(2):168-179. doi: 10.1016/j.semnephrol.2021.03.011.

Authors

Ayman Al Jurdi¹, Janaina Da Silva Martins², Leonardo V Riella³

Affiliations

¹ Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
² Center for Molecular Medicine, Maine Medical Center Research Institute, Scarborough, ME.
³ Center for Transplantation Sciences, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: lriella@mgh.harvard.edu.

PMID: 34140095
DOI: 10.1016/j.semnephrol.2021.03.011

Abstract

Bone disease after kidney transplantation is associated with an increased risk of fractures, morbidity, and mortality. Its pathophysiology is complex, involving multiple contributors including pretransplant bone disease, immunosuppressive medications, and changes in the parathyroid-bone-kidney axis. Risk scores, bone turnover markers, and noninvasive imaging modalities are only able to partially predict the fracture risk in kidney transplant recipients. The optimal management of bone disease after kidney transplantation has not yet been established, with only a limited number of randomized clinical trials evaluating the efficacy of treatment regimens in kidney transplant recipients. This review focuses on the pathophysiology, evaluation, prevention, and treatment of post-kidney transplant mineral and bone disease as guided by recent evidence.

Keywords: Kidney transplant; MBD; fracture; mineral bone disorder; osteoporosis.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Bone Density
Bone Diseases* / etiology
Fractures, Bone*
Humans
Kidney Transplantation*
Minerals

Substances

Minerals