Endocrine Abstracts (2009) 20 P231

Bone and mineral metabolism before and after kidney-pancreas transplantation in patients with type 1 diabetes

Daniel Vaz, L Martins, L Dias, C Henriques, F Oliveira, R Seca, A Lhamas, S Esteves, A Ribeiro, R Almeida, M Teixeira & J Dores

Centro Hospitalar do Porto, Porto, Portugal.

Aims: End stage renal disease is associated with disorders of calcium and phosphate metabolism that favor the loss of bone mass.

Kidney transplant may alter this unbalance restoring bone mass. Nevertheless, recent studies showed that 48 months after transplant, the loss of bone mass still is superior to general population. Post-transplant corticosteroid therapy is considered the main responsible for the loss of bone mass.

The authors present a 5 year retrospective analysis of markers of bone metabolism after kidney–pancreas transplant.

Methods: The study included 40 transplant recipients (25 women; 15 men), age between 20 and 47 years (33.6±6.3 years), that have completed 5 years of follow-up.

We analyzed the following markers of bone metabolism until the 5th year post-transplant:

–Lumbar spine and hip Bone mineral density (BMD) determined by DXA;

–Plasma levels of calcium, phosphorus, parathyroid hormone (PTH), vitamin D, bone-specific alkaline phosphatase, osteocalcin and Beta Cross Laps

Results: Five years post-transplant, lumbar spine and femoral BMD (T score) increased 42.2% and 15.9% respectively.

Plasma levels of calcium, phosphorus and PTH decreased 5.4%, 25% e 66.8%, respectively.

Plasma levels of bone-specific alkaline phosphase, osteocalcin and beta cross laps decreased 63%, 65.8% e 93% respectively.

Vitamin D levels increased 86.7%.

Conclusions: In our population of transplant recipients, there was an increase in BMD at the 5th year post-transplant, bone turnover decreased favoring bone formation.