Low dose pamidronate for treatment of early bone loss following kidney transplantation. A randomized controlled trial
Shahidi S, Ashrafi, F et alIranian Journal of Kidney Diseases 2015; 9(1): 50-5
Aims
To determine the effects of pamidronate therapy on kidney transplant recipients’ bone mineral density
Interventions
Pamidronate (30mg intravenous infusion) or control group not receiving pamidronate. All patients received oral calcium carbonate, vitamin D and triple agent immunosuppression with cyclosporine, mycophenolate mofetil and corticosteroids.
Participants
40 kidney transplant recipients randomised to pamidronate (n=16) or control (n=24)
Outcomes
Primary endpoint was bone mineral density changes in the lumbar vertebrae, femur, or femur neck.
Follow-up
6 months
CET Conclusions
In this study 40 patients were randomised after living donor renal transplantation, all of whom received triple immunosuppression with cyclosporine, MMF and steroids, to either low dose bisphosphonate, pamidronate, or not. All patients received calcium and vitamin D supplementation. Laboratory parameters and bone density of the lumbar spine and femoral neck were measured at baseline and 6 months after kidney transplantation. At 6 months there was no difference in the bone density or in any other laboratory parameters. The PTH levels normalised in both groups by 6 months after transplantation. The authors suggest that administration of calcium and vitamin D following living donor renal transplantation may be beneficial and may prevent substantial bone loss occurring within the 6 months after transplantation but also suggest that the addition of a bisphosphonate pamidronate (in low doses but given by intravenous infusion) has no beneficial effects. These results are contradictory to some other reported results, but as the authors suggest they have only followed their patients for 6 months and they were using low dose pamidronate which may explain the different results.
Data analysis
Per protocol analysis
Trial registration
IRCT 138903252417N2