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Mineral and bone disorders in kidney transplant recipients: reversible, irreversible, and de novo abnormalities

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Abstract

Given the advances in medical technologies related to kidney transplantation, the post-transplant graft survival rate and quality of life have improved dramatically. Nevertheless, post-transplant mortality rate still remains high as compared to the general population due to the development of cardiovascular events. It has recently been widely recognized that chronic kidney disease-mineral and bone disorders (CKD-MBD) significantly contribute to such poor prognosis at least in part. In the majority of kidney recipients, abnormal serum parameters for mineral and bone disorder (MBD), such as phosphorus, calcium, 1,25-dihydroxyvitamin D, parathyroid hormone and fibroblast growth factor 23, gradually return toward acceptable levels following the re-establishment of kidney function after transplantation; however, some irreversible abnormalities, developed as the result of long-term dialysis, persist, require treatment, or even progress after kidney transplantation. Thus, better management of CKD-MBD during pre-dialysis and dialysis period as well as after kidney transplantation is highly appreciated.

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Conflict of interest

Takashi Hirukawa declared no conflict of interest. Takatoshi Kakuta received honoraria from Kyowa Hakko Kirin and Chugai Pharmaceutical Co. Ltd, Japan. Michio Nakamura declared no conflict of interest. Masafumi Fukagawa received honoraria from Kyowa Hakko Kirin, Bayer Japan and Torii, manuscript fees from Kyowa Hakko Kirin, and research funding from Kyowa Hakko Kirin.

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Authors and Affiliations

  1. Division of Nephrology, Endocrinology and Metabolism, Department of Medicine, Tokai University School of Medicine, 143 Shimo-Kasuya, Isehara, Kanagawa, 259-1193, Japan

    Takashi Hirukawa & Masafumi Fukagawa

  2. Division of Nephrology, Endocrinology and Metabolism, Department of Medicine, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan

    Takatoshi Kakuta

  3. Division of Transplantation, Department of Surgery, Tokai University School of Medicine, Isehara, Japan

    Michio Nakamura

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  1. Takashi Hirukawa
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  2. Takatoshi Kakuta
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  4. Masafumi Fukagawa
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Correspondence to Masafumi Fukagawa.

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Hirukawa, T., Kakuta, T., Nakamura, M. et al. Mineral and bone disorders in kidney transplant recipients: reversible, irreversible, and de novo abnormalities. Clin Exp Nephrol 19, 543–555 (2015). https://doi.org/10.1007/s10157-015-1117-z

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