Transplantation osteoporosis

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Abstract

Improved survival rates necessitate a greater awareness of long-term complications of transplantation such as fractures and osteoporosis. Patients with chronic kidney disease who have low bone mineral density (BMD) and bone turnover markers in the upper half of the normal premenopausal range are at the highest risk of fracture. Osteoporotic BMD affects up to 40% of patients with congestive heart failure, with a 2.5-fold increase in fracture risk. Low body mass index before liver transplant, cholestatic liver disease and older age are important risk factors for osteoporosis. Bone loss in stem cell transplantation (SCT) recipients is related both to the underlying diseases and to chemotherapeutic drugs. Glucocorticoids exposure varies with the organ transplanted and the number of rejection episodes. Preventive therapy initiated in the immediate posttransplantation period is indicated in patients with osteopenia or osteoporosis, because further bone loss will occur immediately after transplantation.

Original languageEnglish
Title of host publicationPrimer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism
PublisherWiley-Academy
Chapter54
Pages424-435
Number of pages12
Edition9th
ISBN (Electronic)9781119266594
ISBN (Print)9781119266563
DOIs
Publication statusPublished - 2019

Keywords

  • Bone mineral density
  • Chemotherapeutic drugs
  • Chronic kidney disease
  • Congestive heart failure
  • Glucocorticoids
  • Liver transplant
  • Osteoporosis
  • Preventive therapy
  • Stem cell transplantation

Cite this

Ebeling, P. R. (2019). Transplantation osteoporosis. In Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism (9th ed., pp. 424-435). Wiley-Academy. https://doi.org/10.1002/9781119266594.ch54