A PROSPECTIVE STUDY OF POST RENAL TRANSPLANT MINERAL BONE DISORDER: A SINGLE CENTER EXPERIENCE

Abstract

To evaluate sequential changes in biochemical bone parameters, parathyroid hormone (iPTH), and vitamin D levels over a period of 24 weeks after renal transplantation, we studied 52 patients (41 males, with a mean age of 31.98.) who underwent their first renal transplantation without a past history of parathyroid surgery or fractures. Serum calcium, phosphorus, albumin, Serum iPTH and vitamin D levels were measured before transplant, then at 2, 4, 12 and 24 weeks post transplantation. Serum calcium showed a significant increase from 2 to 12 weeks after transplantation, followed by a slight decline until 24 weeks. At the end of 12 and 24 weeks, 6 (11.53%) and 2 (3.8%) patients had hypercalcemia respectively. At the end of 12 weeks only 15.38% (8) patients had hypocalcemia and no patient had hypocalcemia at the end of 24 weeks. Serum phosphorus showed significant decline in the first 4 weeks post transplantation. At the end of 24 weeks 21.2% still had hypophosphatemia. iPTH levels declined rapidly in the first 4 weeks of post transplant period and there after decline slowly till the end of 24 weeks. Baseline iPTH and vitamin D3 levels did not correlate with persistent HPT. Hypovitaminosis D was seen in 16 (30.7%), 8 (15.3 %) and 11 (21.1%) patients at pretransplant, 12, and 24 weeks post transplant respectively. Unlike most studies in literature our patient population experienced lower prevalence of post transplant hypercalcemia, Hypovitaminosis D, and hyperparathyroidism which may have resulted from younger study population and shorter dialysis vintage.