Mineral and Bone Disease (MBD) on a Kidney Transplant Patient

• Main Author: Birne, R
• Publication Date: 2014
• Other Authors: Adragão, T, Ferreira, A, Dickson, J, Silva, R, Casqueiro, A, Oliveira, R, Martins, AR, Torres, J, Matias, P, Branco, P, Jorge, C, Weigert, A, Bruges, M, Machado, D
• Format: Article
• Language: eng
• Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
• Download full: http://hdl.handle.net/10400.17/1794
• topic: HCC NEF; Biópsia; Hipercalcemia; Transplantação de Rim; Osteoporose

A 50-year-old post-menopausal recipient of a kidney allograft with bone pain, osteoporosis, persistent hypercalcaemia and elevated parathormone (PTH) levels, despite a satisfactory graft function, was treated with bisphosphonates and cinacalcet starting, respectively, 5 and 6 months after renal transplantation (RT). Sixteen months after treatment, there was improvement of bone mineral density (BMD) measured by dualenergy X-ray absorptiometry (DEXA). A bone biopsy was taken, unveiling a surprising and worrisome result. Post-RT bone disease is different from classic CKD-MBD and should be managed distinctly, including, in some difficult cases, an invasive evaluation through the performance of a bone biopsy, as suggested in the KDIGO guidelines.