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Mineral and Bone Disorders Following Renal Transplantation

  • Hatem AmerEmail author
  • Rajiv KumarEmail author
Chapter

Abstract

Bone disease and abnormalities in bone mineral metabolism occur in patients following renal transplantation. Bone demineralization and an increase in fractures of the hip and spine are noted. Many of the abnormalities are due to the administration of glucocorticoids on a background of pre-existing renal bone disease (either hyperparathyroidism or low-turnover bone disease). Appropriate treatment of bone disease prior to transplantation, the administration of vitamin D and its analogs and bisphosphonates, limiting the amount of steroid administered, and exploring the use of “steroid-free” immunosuppression are strategies that have a salutary effect on bone outcomes. We also discuss potential mineral and bone abnormalities that occur in live kidney donors, as it is apparent that these individuals who represent almost 30% of all renal organ donors experience alterations in calcium and phosphorus metabolism as well as changes in calciotropic hormones and phosphate-regulating factors.

Keywords

Transplantation Bone disease Hyperparathyroidism Glucocorticoids Calcineurin inhibitors Fractures Paricalcitol 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Nephrology and Hypertension, Department of Internal MedicineMayo ClinicRochesterUSA
  2. 2.Division of Nephrology and Hypertension, Departments of Internal Medicine, Biochemistry, and Molecular BiologyMayo ClinicRochesterUSA

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