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

• Author(s): Birne, R ; 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
• Date: 2014
• Persistent ID: http://hdl.handle.net/10400.17/1794
• Origin: Repositório do Centro Hospitalar de Lisboa Central, EPE
• Subject(s): HCC NEF; Biópsia; Hipercalcemia; Transplantação de Rim; Osteoporose
• Document Type: Article
• Language: English

Description

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.