CONTINUING LOSS OF VERTEBRAL MINERAL DENSITY IN RENAL-TRANSPLANT RECIPIENTS

This cross-sectional study examined bone abnormalities by digital radi ography, bone densitometry and biochemical tests in 44 clinically asym ptomatic renal transplant recipients 6-195 months after renal transpla ntation. Abnormal radiographs were obtained in 40 of the 44 patients. Dual-energy X-ray absorptiometry (DXA) performed at the lumbar spine ( L2-L4)/showed a negative Z score in all patients, ranging from -1 to - 1.9 in 28 patients and less than -2.0 in 16 patients. The severity of osteopenia increased with the length of time after transplantation and there was a significant correlation with parathyroid hormone values i n patients with normal and low glomerular filtration rates. Our data s uggest that decreased bone density values (Z score less than -2) are p resent in about one-third of patients with renal transplants. Bone los s appears to continue after transplantation. Steroid therapy and immun otherapy are probably the cause of this bone loss. Bone mineral measur ements alone are helpful in identifying asymptomatic patients with low bone mass after transplantation.