Mineral and bone disorders in kidney transplant recipients: reversible, irreversible, and de novo abnormalities

• Published in: Clinical and Experimental Nephrology Vol. 19; no. 4; pp. 543 - 555
• Main Authors: Hirukawa, Takashi, Kakuta, Takatoshi, Nakamura, Michio, Fukagawa, Masafumi
• Format: Journal Article Book Review
• Language: English
• Published: Tokyo Springer Japan 01-08-2015; Springer Nature B.V
• Subjects: Chronic Kidney Disease-Mineral and Bone Disorder - etiology; Chronic Kidney Disease-Mineral and Bone Disorder - mortality; Chronic Kidney Disease-Mineral and Bone Disorder - therapy; Humans; Kidney Transplantation; Medicine; Medicine & Public Health; Nephrology; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - therapy; Review Article; Urology; Phosphorus; Bone; Calcium; Parathyroid; CKD-MBD; Kidney transplantation
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-015-1117-z

Given the advances in medical technologies related to kidney transplantation, the post-transplant graft survival rate and quality of life have improved dramatically. Nevertheless, post-transplant mortality rate still remains high as compared to the general population due to the development of cardiovascular events. It has recently been widely recognized that chronic kidney disease-mineral and bone disorders (CKD-MBD) significantly contribute to such poor prognosis at least in part. In the majority of kidney recipients, abnormal serum parameters for mineral and bone disorder (MBD), such as phosphorus, calcium, 1,25-dihydroxyvitamin D, parathyroid hormone and fibroblast growth factor 23, gradually return toward acceptable levels following the re-establishment of kidney function after transplantation; however, some irreversible abnormalities, developed as the result of long-term dialysis, persist, require treatment, or even progress after kidney transplantation. Thus, better management of CKD-MBD during pre-dialysis and dialysis period as well as after kidney transplantation is highly appreciated.