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NDT Advance Access published online on December 1, 2007
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfm816
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Bone Disease after Renal Transplantation

Ulrich Kunzendorf1, Bernhard Krämer2, Wolfgang Arns3, Johann Braun4, Jan Grossmann4, Frank Pietruck5, Heinrich Schmidt-Gayk6, Anke Schwarz7, Ekkehard Ziegler1, Heide Sperschneider4, Rudolf P. Wüthrich8, Barbara Nonnast-Daniel9, Ralf Schindler10 and Lutz Renders1

1 Division of Nephrology and Hypertension, University of Kiel, Germany 2 Division of Nephrology, University of Regensburg, Germany 3 Department of Internal Medicine, Kliniken der Stadt Köln, Germany 4 Kuratorium für Dialyse und Transplantation, Frankfurt-Neu-Isenburg, Germany 5 Division of Nephrology, University of Essen, Germany 6 Labor Dr. Limbach and colleagues, Heidelberg, Germany 7 Department of Nephrology, Medizinische Hochschule, Hannover, Germany 8 Clinic for Nephrology, University of Zürich, Switzerland 9 Department of Nephrology and Hypertension, University of Erlangen, Germany 10 Department of Nephrology, Charité, Berlin, Germany

Correspondence and offprint requests to: Ulrich Kunzendorf, Division of Nephrology, University of Kiel, Schittenhelmstrasse 12, D-24105 Kiel, Germany. Tel: +49-431-597-1336; Fax: +49-431-597-1337; E-mail: kunzendorf@nephro.uni-kiel.de

Keywords: hyperparathyroidism; kidney transplantation; renal osteopathy

The first 150 words of the full text of this article appear below.



   Introduction
 
Because of increasing life expectancy after renal transplantation, the prevention of long-term complications, such as bone disease, has become an essential part of post-renal-transplant care. Bone disease is one of the possible long-term complications that can significantly influence quality of life. Compared to members of the normal population of the same age, the fracture rate in renal transplant patients is four times higher. In addition, there is a risk for avascular bone necrosis after transplantation, which mainly affects weight-bearing bone structures, such as femoral heads, and as a rule, can only be treated by hip replacement with endoprosthesis. Histological evidence of abnormal bone structure, osteodystrophy and osteopaenia is already present shortly after transplantation in almost all transplant recipients [1].

Bone disease after renal transplantation differs from bone disease after transplantation of non-renal solid organs. Bone disease after non-renal solid organs is often similar to steroid-induced osteoporosis. In addition, . . . [Full Text of this Article]



   Clinical importance of bone disease after renal transplantation
 


   Pathogenesis of bone disease after transplantation
 


   Development of bone disease after renal transplantation
 
Importance of hyperparathyroidism for the development of bone disease
Importance of hypophosphataemia for the development of bone disease
Importance of immunosuppressive agents on the development of bone disease


   Prevention of and therapy for bone disease after transplantation
 
Guidelines for the prevention of bone disease after kidney transplantation
Hypophosphataemia treatment
Hyperparathyroidism therapy after transplantation
Parathyroidectomy
Use of calcimimetics


   Summary
 

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