Bone metabolism and mineral density following renal transplantation

Aim-To study bone turnover following renal transplantation using a panel of biochemical markers and to correlate the results with both areal and volum etric bone mineral density (BMD). Patients-A total of 31 patients aged 18.1 years were transplanted 5.4 years before this study. Control patients (n = 31) were age and gender matched. Methods-In addition to measurement of biochemical markers, BMD was measured by single photon absorptiometry and peripheral quantitative computed tomog raphy on the non-dominant radius. Results-Patients had reduced glomerular filtration rate, raised concentrati ons of serum phosphate, serum procollagene type I carboxy terminal propepti de, osteocalcin, and serum procollagene type I cross linked carboxy termina l telopeptide. The differences were still significant if only patients with normal intact parathyroid hormone were considered. BMD single photon absor ptiometry Z score for age was significantly decreased. Following standardis ation for height the differences were no longer present. With volumetric te chniques patients had normal trabecular but decreased cortical and total BM D compared to age matched controls, but there was no difference from height there was no difference from height matched controls. Conclusion-Markers of bone turnover are increased following renal transplan tation. However, the biochemical analysis did not allow conclusions to be d rawn on the bone mineral content. BMD single photon absorptiometry Z score corrected for height and BMD measured by quantitative computed tomography c ompared to height matched controls were normal in paediatric renal transpla ntation patients. Height matched controls should be used in both areal and volumetric BMD measurements in states of growth failure.