REVERSAL OF ALUMINUM-RELATED BONE-DISEASE AFTER RENAL-TRANSPLANTATION

We evaluated the course of severe aluminum-related bone disease (ARBD) after the first year of a successful renal transplantation (RTx) in 1 1 adult patients. Bone pain and muscle weakness, presented in all pati ents previously to RTx, subsided, and all were able to walk, even the ones who were confined to wheelchairs. Bone necrosis developed in 6 pa tients, but none required surgical repair. Serum alkaline phosphatase activity increased 2.5 times the upper normal level, up to the 5th mon th and then declined to normal levels up the 12th month (p < 0.05). Th e inverse profile was observed in both serum calcium and phosphorus le vels. In bone biopsies, there was a significant decrease in all of the following histomorphometric static parameters: osteoid volume, thickn ess and surface and also in aluminum surface. Also, there was a signif icant increase in all the dynamic parameters of mineralization: minera l apposition rate, mineralization surface, bone formation rate and adj usted apposition rate. In conclusion, ARBD remarkably improves after 1 year of successful RTx.