Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA.
Division of Nephrology and Hypertension, NorthShore University HealthSystem, University of Chicago Medical School, 2650 Ridge Avenue, Evanston, IL, 60201, USA.
Curr Osteoporos Rep. 2018 Dec;16(6):703-711. doi: 10.1007/s11914-018-0490-4.
Despite metabolic improvements following kidney transplantation, transplant recipients still often suffer from complex mineral and bone disease after transplantation.
The pathophysiology of post-transplant disease is unique, secondary to underlying pre-transplant mineral and bone disease, immunosuppression, and changing kidney function. Changes in modern immunosuppression regimens continue to alter the clinical picture. Modern management includes reducing cumulative steroid exposure and correcting the biochemical abnormalities in mineral metabolism. While bone mineral density screening appears to help predict fracture risk and anti-osteoporotic therapy appears to have a positive effect on bone mineral density, more data regarding specific treatment is necessary. Patients with mineral and bone disease after kidney transplantation require special care in order to properly manage and mitigate their mineral and bone disease. Recent changes in clinical management of transplant patients may also be changing the implications on patients' mineral and bone disease.
尽管肾移植后代谢得到改善，但移植受者在移植后仍常患有复杂的矿物质和骨疾病。
移植后疾病的病理生理学是独特的，继发于潜在的移植前矿物质和骨疾病、免疫抑制和肾功能变化。现代免疫抑制方案的改变继续改变临床情况。现代治疗包括减少累积类固醇暴露和纠正矿物质代谢生化异常。虽然骨密度筛查似乎有助于预测骨折风险，抗骨质疏松治疗似乎对骨密度有积极影响，但需要更多关于特定治疗的数据。肾移植后患有矿物质和骨疾病的患者需要特别护理，以正确管理和减轻其矿物质和骨疾病。最近对移植患者临床管理的改变也可能改变患者矿物质和骨疾病的影响。
