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• W4211101314 endingPage "32" @default.
• W4211101314 startingPage "11" @default.
• W4211101314 abstract "Candidates for all types of transplantation have risk factors for osteoporosis, and many have low bone mineral density (BMD), prevalent fractures, and abnormal mineral metabolism. After transplantation, exposure to high doses of glucocorticoids and cyclosporine or tacrolimus has deleterious effects on the skeleton. The majority of patients experience rapid bone loss, and fragility fractures are also common, particularly during the first year posttransplantation. Early posttransplantation bone loss is associated with biochemical evidence of uncoupled bone turnover, with increases in markers of resorption and decreases in markers of formation. Most of the evidence favors the idea that after glucocorticoid doses are tapered, bone formation recovers and transplantation-related bone loss becomes a form of high-turnover osteoporosis. Because significant bone disease frequently antedates transplantation, all patients awaiting transplantation should undergo BMD testing, spine radiographs, and pertinent biochemistry tests. Those with osteoporosis and abnormal mineral metabolism can be identified and treated, and potentially reversible causes of bone loss can be corrected. Because no pretransplantation parameter reliably predicts fracture in the individual patient, most patients should be placed on appropriate pharmacologic therapy immediately after transplantation to prevent bone loss and fractures. Although few data are available from randomized, controlled, clinical trials, both bisphosphonates and calcitriol show promise in the prevention of transplantation osteoporosis." @default.
• W4211101314 created "2022-02-13" @default.
• W4211101314 creator A5009410005 @default.
• W4211101314 creator A5069333159 @default.
• W4211101314 date "2001-01-01" @default.
• W4211101314 modified "2023-10-11" @default.
• W4211101314 title "Transplantation osteoporosis" @default.
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