Role of Alfacalcidol on bone quality on RA-induced osteoporosis and on osteoporosis after different organ transplantations

Journal/Book: Z Rheumatol 1998; 57 Suppl. 1: 7 (V 9). 1998;

Abstract: 1Arthritis and Metabolic Bone Disease Research Unit; 2Division of Cardiology; 3Division of Hepatology; 4Division of Nephrology; 5Division of Pneumology; K. U. Leuven Transplantation cases have been followed prospectively by the bone densitometry unit since 1989: 250 heart transplant 51 liver transplant 115 renal transplant and 19 lung transplant cases. At the time of transplantation the respective mean lumbar spine/femoral neck Z-score was for heart transplant cases -0.97/-0.25 for liver transplant -0.9/-0.8 for renal transplant -1.24/-1.51 and for lung transplant -0.58/-1.55. The lung and kidney transplant cases had Ihe lowest starting bone mineral density at the time of transplantation. Immediately after transplantation there is a considerable loss of spinal and proximal femur bone amounting -7 to -10 % at 6 months. At 12 months there is some further loss of about 2 %. One year after transplantation there is no further loss and even a gain in bone mineral density. The spontaneous recovery in bone mineral density is accelerated and augmented with 1( vitamin D therapy in particular at the spine. In a small double-blind study of heart transplant cases less fractures occured in the 1( vitamin D treatment group (1 - 3). The recovery of bone mineral density at the spine is most marked in the renal and liver transplant cases and may amount up to 8 % above pretransplantation levels. Van Cleemput J. Daenen W. Geusens P. Dequeker J. Van de Werf P. Vanhaecke J.; Transplantation 1996; 61: 1495 - 1499. Van Cleemput J. Daenen W. Nijs J. Geusens P. Dequeker J. Vanhaecke J.; Transplantation International 1995; 8: 196 - 200. Dequeker J. Van Cleemput J. Declerck K. Mbuyi-Muamba J. M.; Calcif Tissue Int 1997; 60: 128 - 129. le

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