Is mineral bone disease common in the kidney transplant population?
Yes. Chronic kidney disease–mineral bone disease (CKD-MBD) is common in kidney transplant recipients. Use of corticosteroids as part of the immunosuppressive regiment may further affect CKD-MBD management. Studies have demonstrated a rapid decrease in bone mineral density in the first 6 to 12 months after transplantation. In addition, fractures are common in kidney transplant recipients and are associated with substantial morbidity. Monitoring bone mineral density should be routine for all patients taking chronic corticosteroids. Monitoring parathyroid hormone is also important, particularly in the setting of high calcium. It takes 3 to 6 months for PTH to start to decrease. Bisphosphonate administration is often necessary to maintain and restore bone mineral density, particularly in the setting of chronic steroid and immunosuppressant use. Bisphosphonate use has not shown decreased fracture incidence.
