TY - JOUR
T1 - Contemporary kidney transplantation has a limited impact on bone microarchitecture
AU - Meng, Catarina
AU - Jørgensen, Hanne Skou
AU - Verlinden, Lieve
AU - Bravenboer, Nathalie
AU - de Loor, Henriette
AU - D'Haese, Patrick C.
AU - Carmeliet, Geert
AU - Evenepoel, Pieter
N1 - Funding Information: HSJ was supported by a European Renal Association (ERA) long-term fellowship during the completion of this work. This research did not receive further specific grants from funding agencies in the public, commercial, or not-for-profit sectors. Publisher Copyright: © 2022
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Bone microarchitecture is an important component of bone quality and disturbances may reduce bone strength and resistance to trauma. Kidney transplant recipients have an excess risk of fractures, and bone loss affecting both trabecular and cortical bone compartments have been demonstrated after kidney transplantation. The primary aim of this study was to investigate the impact of kidney transplantation on trabecular and cortical bone microarchitecture, assessed by histomorphometry and micro computed tomography (μCT). Iliac crest bone biopsies, analyzed by bone histomorphometry and μCT, were performed at time of kidney transplantation and 12 months post-transplantation in an unselected cohort of 30 patients. Biochemical markers of mineral metabolism and bone turnover were measured at both time-points. At 12 months post-transplantation, bone turnover was low in 5 (17%) and normal in 25 (83%) patients. By histomorphometry, bone remodeling normalized, with decreases in eroded perimeters (4.0 to 2.1%, p = 0.02) and number of patients with marrow fibrosis (41 to 0%, p < 0.001). By μCT, trabecular thickness (134 to 125 μM, p = 0.003) decreased slightly. Other parameters of bone volume and microarchitecture, including cortical thickness (729 to 713 μm, p = 0.73) and porosity (10.2 to 9.5%, p = 0.15), remained stable. We conclude that kidney transplantation with current immunosuppressive protocols has a limited impact on bone microarchitecture.
AB - Bone microarchitecture is an important component of bone quality and disturbances may reduce bone strength and resistance to trauma. Kidney transplant recipients have an excess risk of fractures, and bone loss affecting both trabecular and cortical bone compartments have been demonstrated after kidney transplantation. The primary aim of this study was to investigate the impact of kidney transplantation on trabecular and cortical bone microarchitecture, assessed by histomorphometry and micro computed tomography (μCT). Iliac crest bone biopsies, analyzed by bone histomorphometry and μCT, were performed at time of kidney transplantation and 12 months post-transplantation in an unselected cohort of 30 patients. Biochemical markers of mineral metabolism and bone turnover were measured at both time-points. At 12 months post-transplantation, bone turnover was low in 5 (17%) and normal in 25 (83%) patients. By histomorphometry, bone remodeling normalized, with decreases in eroded perimeters (4.0 to 2.1%, p = 0.02) and number of patients with marrow fibrosis (41 to 0%, p < 0.001). By μCT, trabecular thickness (134 to 125 μM, p = 0.003) decreased slightly. Other parameters of bone volume and microarchitecture, including cortical thickness (729 to 713 μm, p = 0.73) and porosity (10.2 to 9.5%, p = 0.15), remained stable. We conclude that kidney transplantation with current immunosuppressive protocols has a limited impact on bone microarchitecture.
KW - Bone density
KW - Bone histomorphometry
KW - Chronic kidney disease – mineral and bone disorder
KW - Kidney transplantation
KW - Osteoporosis
KW - X-Ray Microtomography
UR - http://www.scopus.com/inward/record.url?scp=85124398097&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.bonr.2022.101172
DO - https://doi.org/10.1016/j.bonr.2022.101172
M3 - Article
C2 - 35198658
SN - 2352-1872
VL - 16
JO - Bone Reports
JF - Bone Reports
M1 - 101172
ER -