BONE-MINERAL STATUS AFTER RENAL-TRANSPLANTATION - ASSESSMENT BY NONINVASIVE TECHNIQUES

RATIONALE AND OBJECTIVES. Bone mineral status in recipients of renal g rafts is related to preexisting renal osteodystrophy and immunosuppres sive treatment. The authors assessed bone mineral status after renal t ransplantation. METHODS. Bone mineral status of 20 male graft recipien ts was evaluated using the following noninvasive techniques: 1) neutro n activation analysis, to measure hand bone phosphorus (HBP); 2) singl e photon absorptiometry, to measure forearm bone mineral content (BMC) ; and 3) single energy spectrum quantitative computed tomography, to m easure spinal trabecular bone equivalent density (TBED).RESULTS. The m ean (+/-SD, P) HBP, BMC, and TBED were found to be respectively, 4.8% (+/-8.3%, P = .02), 6.6% (+/-14.6%, P = .07) and 52% (+/-8.5%, P < .00 1) lower than that measured in matched normal controls. Renal graft re cipients demonstrated mean HBP and BMC decrements that were similar to those observed in matched patients on extrarenal dialysis, although t he decrement in TBED was significantly greater in the graft recipients (P < .001). Repeated measurements performed during a 3-year period sh owed no statistically significant changes.CONCLUSIONS. Renal transplan tation was associated with minor degree of osteopenia in the primarily cortical bone tissue. We speculate that the remarkably low TBED value s in graft recipients does not reflect a mean 52% decrement of spinal bone minerals, but rather may be attributed in part to the deposition of adipose tissue in the spine as a result of corticosteroid treatment .