Abstract
Bone turnover markers [osteocalcin (OC), carboxyterminal procollagen I propeptide (PICP), bone alkaline phosphatase (bALP), deoxypyridinoline (DPD), β -crosslaps (CTX), bone acid phosphatase (bACP), parathyroid hormone (PTH)], day calcium excretion (uCaV) and lumbar and hip bone mineral content (BMC) were determined in 195 patients [78 women and 74 men with intact renal function as well as 11 women and 31 men with renal failure (RF)] 40±33 months following KT. KT recipients received triple immunosuppressive therapy (CysA, prednisolone and azathioprine). All groups showed bone remodeling dissociation namely bone resorption increase (high CTX, DPD, bACP) and bone formation retard (mild enhanced level OC, normal or low bALP) in association with high PTH, decreased uCaV and BMC levels. High bone turnover and low uCaV were much more high degree in RF. Vertebral and femur BMC decrease was mild (osteopenia) and only men with RF revealed peripheral osteoporosis. Hyperparathyroidism was associated with decreased transplant function and was main predictor of high bone turnover and bone loss after KT.
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