Pamidronate used to attenuate post-renal transplant bone loss is not associated with renal dysfunction.

BACKGROUND

Pamidronate is a second-generation bisphosphonate that has been used to attenuate post-renal transplant bone loss, but its effect on the function of the renal allograft is unclear. Therefore, we evaluated the long-term renal function in 57 subjects who had participated in a prospective, randomized clinical trial using pamidronate to attenuate bone loss in the renal transplant recipient.

METHODS

Thirty subjects (PAM) received intravenous pamidronate, 60 mg at baseline post-transplant and 30 mg in months 1, 2, 3 and 6 post-transplant, while 27 subjects (CON) did not receive pamidronate. We followed renal function, need for renal replacement therapy following transplant rejection, and mortality for 3 years following the start of the original study.

RESULTS

PAM did not have increased incidence of renal dysfunction or mortality compared with CON at any time point during the 3 years of follow-up. The incidence of proteinuria was also not different between the two groups.

CONCLUSIONS

The prophylactic use of pamidronate in the above doses to attenuate bone loss in renal transplant recipients is not associated with higher incidence of renal dysfunction or mortality in a 3 year follow-up study. These findings may support the use of bisphosphonates in the treatment of early renal transplant-related bone loss.