A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents
Article first published online: 26 AUG 2004
American Journal of Transplantation
Volume 4, Issue 12, pages 2052–2057, December 2004
How to Cite
El-Husseini, A. A., El-Agroudy, A. E., El-Sayed, M., Sobh, M. A. and Ghoneim, M. A. (2004), A Prospective Randomized Study for the Treatment of Bone Loss with Vitamin D During Kidney Transplantion in Children and Adolescents. American Journal of Transplantation, 4: 2052–2057. doi: 10.1111/j.1600-6143.2004.00618.x
- Issue published online: 26 AUG 2004
- Article first published online: 26 AUG 2004
- Received 30 March 2004, revised and accepted for publication 20 July 2004
- Bone disease;
- renal transplantation;
- vitamin D
The effect of treatment with alfacalcidol on post-transplantation bone loss in children and adolescents was investigated.
Of the 63 young patients who received renal transplant and were subjected to dual-energy x-ray absorptiometry (DEXA), 30 patients had low-bone mineral density (BMD) (z-score ≤−1) and were enrolled into the study. Their mean age at the time of transplantation was 14.5 ± 4.0 years and the mean duration after transplantation was 48 ± 34 months. Patients with low BMD were randomized into two equal homogeneous groups: group 1 (control) received placebo and group 2 received daily alfacalcidol 0.25 μg by mouth. Parameters of bone metabolism (intact parathyroid hormone, serum osteocalcin and urinary deoxypyridinoline) and BMD were assessed before and after the study period.
After 12 months of treatment BMD at the lumber spine decreased from −2.2 to −2.5 in group 1 while it increased from −2.1 to −0.6 in group 2 (p < 0.001). Serum intact parathyroid hormone level decreased significantly in group 2 (p = 0.042). Apart from transient hypercalcemia in 1 patient in group 2, no other significant adverse effects were noted.
This study suggested the value of alfacalcidol in the treatment of bone loss in young renal transplant recipients.