Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega Efficacy of pamidronate in prevention of bone loss after renal transplantation

摘要

Introduction: Bone loss in kidney transplant recipients presents an importantudproblem since it adds on already present uremic osteodistrophy. Additional bone lossudis mostly caused by immunosuppressive therapy (corticosterodis) which followsudtransplantation. It has been shown that bone loss is most significant during the firstud12 months after renal transplantation.udBisphosphonates are drugs that reduce bone loss and are effective inudtreatment of diseases that affect bone metabolism. There are some studies reportingudthat bisphosphonates attenuate bone loss in kidney transplant recipients. However,udno consensus has been reached on dosage, initiation and duration of the treatment.udAim of this study is to test the effectiveness of low dose pamidronate in boneudloss prevention during the first year after renal transplantation. ----- Patients and methods: In this study 35 patients were included after successfuludrenal transplantation in UHC Zagreb. Intervention group (n=19) received two doses ofud0.5 mg/kg pamidronate, during first month after transplantation and three monthsudafter the first dose. Control group consisted of 17 patients. Bone density wasudmeasured by dual energy X-ray absorptiometry (DXA) during hospitalization for renaludtransplantation, then six and twelve months after renal transplantation. ----- Results: This study confirmed protective effect of low doses pamidronate onudbone in the early period after renal transplantation. Pamidronate significantly reducedudbone loss on lumbar spine and at Ward's area of femur at six months after renaludtransplantation. There were no negative effects of pamidronate on graft function. ----- Conclusion: Low dose pamidronate reduces bone loss in the early period afterudrenal transplantation. It is possible to recommend this application scheme forudprevention of bone loss. Further studies are needed to answer in which patientsudapplication of bisphosphonates would be medically and economically justified.