Oral alendronate can suppress bone turnover but not fracture in kidney transplantation recipients with hyperparathyroidism and chronic kidney disease

Sakura Yamamoto, Atsushi Suzuki, Hitomi Sasaki, Sahoko Sekiguchi-Ueda, Shogo Asano, Megumi Shibata, Nobuki Hayakawa, Shuji Hashimoto, Kiyotaka Hoshinaga, Mitsuyasu Itoh

研究成果: Article

10 引用 (Scopus)

抄録

Post-transplantation bone diseases negatively affect the quality of life of solid organ recipients. Secondary or tertiary hyperparathyroidism is a frequent complication in kidney transplantation (KTx) recipients. Treatment with immunosuppressive agents including glucocorticoids can lead to deterioration in bone metabolism in these patients. In the present study, we explored the effects of a three-year treatment period with oral alendronate (ALN) in long-term KTx recipients. Post-KTx recipients were recruited (n = 24, M/F = 12/12, mean age 52.0 ± 7.8 years) into this study. All patients were prescribed methylprednisolone (4.07 ± 0.86 mg/day) with various immunosuppressive agents. Before treatment with oral ALN (35 mg/week), the mean concentrations of intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D were 139.2 ± 71.4 pg/mL and 20.8 ± 4.1 ng/mL, respectively. After 36 months of ALN treatment, mean iPTH levels increased slightly (+20.9 %). Treatment with ALN reduced bone-specific alkaline phosphatase (-35.4 %), serum type I collagen N-terminal telopeptide (-31.2 %) and osteocalcin (-55.6 %) levels. ALN did not increase bone mass after 24 months. Four patients with the highest baseline iPTH levels suffered a clinical osteoporotic fracture during the 36-month ALN treatment period. Higher iPTH levels with chronic kidney disease (CKD) at baseline were associated with the incidence of new clinical fractures during ALN treatment. In conclusion, anti-resorptive therapy with ALN can suppress bone turnover even when iPTH concentration is elevated in long-term KTx recipients. However, hyperparathyroidism with CKD seems to be associated with new clinical fractures during ALN treatment.

元の言語English
ページ(範囲)116-122
ページ数7
ジャーナルJournal of Bone and Mineral Metabolism
31
発行部数1
DOI
出版物ステータスPublished - 01-01-2013

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Alendronate
Hyperparathyroidism
Bone Remodeling
Chronic Renal Insufficiency
Kidney Transplantation
Parathyroid Hormone
Therapeutics
Immunosuppressive Agents
Bone and Bones
Osteoporotic Fractures
Bone Diseases
Osteocalcin
Methylprednisolone
Glucocorticoids
Alkaline Phosphatase
Transplantation
Quality of Life

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology

これを引用

Yamamoto, Sakura ; Suzuki, Atsushi ; Sasaki, Hitomi ; Sekiguchi-Ueda, Sahoko ; Asano, Shogo ; Shibata, Megumi ; Hayakawa, Nobuki ; Hashimoto, Shuji ; Hoshinaga, Kiyotaka ; Itoh, Mitsuyasu. / Oral alendronate can suppress bone turnover but not fracture in kidney transplantation recipients with hyperparathyroidism and chronic kidney disease. :: Journal of Bone and Mineral Metabolism. 2013 ; 巻 31, 番号 1. pp. 116-122.
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abstract = "Post-transplantation bone diseases negatively affect the quality of life of solid organ recipients. Secondary or tertiary hyperparathyroidism is a frequent complication in kidney transplantation (KTx) recipients. Treatment with immunosuppressive agents including glucocorticoids can lead to deterioration in bone metabolism in these patients. In the present study, we explored the effects of a three-year treatment period with oral alendronate (ALN) in long-term KTx recipients. Post-KTx recipients were recruited (n = 24, M/F = 12/12, mean age 52.0 ± 7.8 years) into this study. All patients were prescribed methylprednisolone (4.07 ± 0.86 mg/day) with various immunosuppressive agents. Before treatment with oral ALN (35 mg/week), the mean concentrations of intact parathyroid hormone (iPTH) and 25-hydroxyvitamin D were 139.2 ± 71.4 pg/mL and 20.8 ± 4.1 ng/mL, respectively. After 36 months of ALN treatment, mean iPTH levels increased slightly (+20.9 {\%}). Treatment with ALN reduced bone-specific alkaline phosphatase (-35.4 {\%}), serum type I collagen N-terminal telopeptide (-31.2 {\%}) and osteocalcin (-55.6 {\%}) levels. ALN did not increase bone mass after 24 months. Four patients with the highest baseline iPTH levels suffered a clinical osteoporotic fracture during the 36-month ALN treatment period. Higher iPTH levels with chronic kidney disease (CKD) at baseline were associated with the incidence of new clinical fractures during ALN treatment. In conclusion, anti-resorptive therapy with ALN can suppress bone turnover even when iPTH concentration is elevated in long-term KTx recipients. However, hyperparathyroidism with CKD seems to be associated with new clinical fractures during ALN treatment.",
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Oral alendronate can suppress bone turnover but not fracture in kidney transplantation recipients with hyperparathyroidism and chronic kidney disease. / Yamamoto, Sakura; Suzuki, Atsushi; Sasaki, Hitomi; Sekiguchi-Ueda, Sahoko; Asano, Shogo; Shibata, Megumi; Hayakawa, Nobuki; Hashimoto, Shuji; Hoshinaga, Kiyotaka; Itoh, Mitsuyasu.

:: Journal of Bone and Mineral Metabolism, 巻 31, 番号 1, 01.01.2013, p. 116-122.

研究成果: Article

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T1 - Oral alendronate can suppress bone turnover but not fracture in kidney transplantation recipients with hyperparathyroidism and chronic kidney disease

AU - Yamamoto, Sakura

AU - Suzuki, Atsushi

AU - Sasaki, Hitomi

AU - Sekiguchi-Ueda, Sahoko

AU - Asano, Shogo

AU - Shibata, Megumi

AU - Hayakawa, Nobuki

AU - Hashimoto, Shuji

AU - Hoshinaga, Kiyotaka

AU - Itoh, Mitsuyasu

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