F P Tillmann1, M Schmitz2, M Jäger3, R Krauspe4, L C Rump2. 1. Klinik für Nephrologie, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. frank.tillmann@uni-duesseldorf.de. 2. Klinik für Nephrologie, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany. 3. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Germany. 4. Orthopädische Klinik, Heinrich Heine Universität Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Abstract
BACKGROUND: Bone mineral density (BMD) has been reported to increase without specific treatment in long-term renal transplant recipients. The aim of this study was to evaluate the effect of ibandronate on BMD and kidney function in long-term renal transplant recipients as compared to a control group. Furthermore, we searched for a gender-specific treatment effect of ibandronate on BMD. METHODS: In a retrospective, matched case-control study 60 stable renal transplant recipients were included on long-term follow-up. The patient cohort was divided into two groups. The control group (n = 30) comprised patients with close-to-normal bone mineral density who did not receive ibandronate treatment and the treatment group (n = 30) comprised patients with reduced bone mineral density who received ibandronate treatment. The groups were matched for sex, age at the time of renal transplantation, use of steroids, renal transplant function and time lag between the dual-energy X-ray absorptiometry (DEXA) measurements and renal transplantation. Patients of the treatment group were treated with 12.0 ± 6.7 g ibandronate. Treatment cycles lasted 19.3 ± 11.0 months. The first bone mineral density testing was performed 55.3 ± 60.2 months after renal transplantation followed by a second measurement 26.8 ± 12.1 months later. RESULTS: Both groups did not differ in absolute (g/cm(2)) or relative (%) changes in BMD at the lumbar spine (0.033 ± 0.079 vs. 0.055 ± 0.066 g/cm(2), p = 0.217 and 3.6 ± 7.8 vs. 6.4 ± 8.1 %, p = 0.124) or femoral neck (0.013 ± 0.106 vs. 0.025 ± 0.077 g/cm(2), p = 0.647 and 3.2 ± 13.6 vs. 5.0 ± 13.1 %, p = 0.544) over the study period. There was no correlation of ibandronate dosages with changes in BMD (LS: r = -0.089; p = 0.639 and FN: r =+0.288; p = 0.445). We could neither determine a negative effect of ibandronate on renal transplant function over the study period, estimated via the CKD-EPI formula (-2.9 ± 7.6 vs. -2.7 ± 10.6 mL/min/1.73 m(2), p = 0.900) nor a gender-specific action of ibandronate on bone mass changes. CONCLUSIONS: Ibandronate treatment was safe with respect to renal transplant function but did not result in a significant additive improvement in bone mineral density as compared to the untreated control group. A gender-specific action of ibandronate on BMD at the LS or FN could not be determined either.
BACKGROUND: Bone mineral density (BMD) has been reported to increase without specific treatment in long-term renal transplant recipients. The aim of this study was to evaluate the effect of ibandronate on BMD and kidney function in long-term renal transplant recipients as compared to a control group. Furthermore, we searched for a gender-specific treatment effect of ibandronate on BMD. METHODS: In a retrospective, matched case-control study 60 stable renal transplant recipients were included on long-term follow-up. The patient cohort was divided into two groups. The control group (n = 30) comprised patients with close-to-normal bone mineral density who did not receive ibandronate treatment and the treatment group (n = 30) comprised patients with reduced bone mineral density who received ibandronate treatment. The groups were matched for sex, age at the time of renal transplantation, use of steroids, renal transplant function and time lag between the dual-energy X-ray absorptiometry (DEXA) measurements and renal transplantation. Patients of the treatment group were treated with 12.0 ± 6.7 g ibandronate. Treatment cycles lasted 19.3 ± 11.0 months. The first bone mineral density testing was performed 55.3 ± 60.2 months after renal transplantation followed by a second measurement 26.8 ± 12.1 months later. RESULTS: Both groups did not differ in absolute (g/cm(2)) or relative (%) changes in BMD at the lumbar spine (0.033 ± 0.079 vs. 0.055 ± 0.066 g/cm(2), p = 0.217 and 3.6 ± 7.8 vs. 6.4 ± 8.1 %, p = 0.124) or femoral neck (0.013 ± 0.106 vs. 0.025 ± 0.077 g/cm(2), p = 0.647 and 3.2 ± 13.6 vs. 5.0 ± 13.1 %, p = 0.544) over the study period. There was no correlation of ibandronate dosages with changes in BMD (LS: r = -0.089; p = 0.639 and FN: r =+0.288; p = 0.445). We could neither determine a negative effect of ibandronate on renal transplant function over the study period, estimated via the CKD-EPI formula (-2.9 ± 7.6 vs. -2.7 ± 10.6 mL/min/1.73 m(2), p = 0.900) nor a gender-specific action of ibandronate on bone mass changes. CONCLUSIONS:Ibandronate treatment was safe with respect to renal transplant function but did not result in a significant additive improvement in bone mineral density as compared to the untreated control group. A gender-specific action of ibandronate on BMD at the LS or FN could not be determined either.
Authors: A Moreno; J V Torregrosa; F Pons; J M Campistol; M J Martínez de Osaba; F Oppenheimer Journal: Transplant Proc Date: 1999-09 Impact factor: 1.066
Authors: K Falkiewicz; M Boratyńska; S C Zmonarski; A Milewicz; D Patrzałek; P Biecek; M Klinger Journal: Transplant Proc Date: 2009-10 Impact factor: 1.066
Authors: S Giannini; A D'Angelo; G Carraro; M Nobile; P Rigotti; L Bonfante; F Marchini; M Zaninotto; L Dalle Carbonare; L Sartori; G Crepaldi Journal: J Bone Miner Res Date: 2001-11 Impact factor: 6.741
Authors: Roberto Marcén; Carmen Caballero; Julio Pascual; José Luis Teruel; Maite Tenorio; Javier Ocaña; Juan José Villafruela; Francisco Javier Burgos; Ana María Fernández; Alfonso Muriel; Joaquín Ortuño Journal: Transplantation Date: 2006-03-27 Impact factor: 4.939
Authors: W H Grotz; F A Mundinger; J Rasenack; L Speidel; M Olschewski; V M Exner; P J Schollmeyer Journal: Nephrol Dial Transplant Date: 1995-11 Impact factor: 5.992
Authors: Christoph Schwarz; Christa Mitterbauer; Georg Heinze; Wolfgang Woloszczuk; Martin Haas; Rainer Oberbauer Journal: Kidney Int Date: 2004-01 Impact factor: 10.612
Authors: John A Eisman; Roberto Civitelli; Silvano Adami; Edward Czerwinski; Chris Recknor; Richard Prince; Jean-Yves Reginster; Mone Zaidi; Dieter Felsenberg; Claire Hughes; Nicole Mairon; Daiva Masanauskaite; David M Reid; Pierre D Delmas; Robert R Recker Journal: J Rheumatol Date: 2008-02-01 Impact factor: 4.666