Long-Term Changes in Parameters of Bone Quality in Kidney Transplant Recipients Treated with Denosumab

被引:0
作者
Pollastri, Francesco [1 ]
Fassio, Angelo [1 ]
Ferraro, Pietro Manuel [2 ]
Andreola, Stefano [2 ]
Gambaro, Giovanni [2 ]
Spasiano, Andrea [2 ]
Caletti, Chiara [2 ]
Stefani, Lisa [2 ]
Gatti, Matteo [3 ]
Fabbrini, Paolo [3 ]
Rossini, Maurizio [1 ]
Galvagni, Isotta [1 ]
Gatti, Davide [1 ]
Adami, Giovanni [1 ]
Viapiana, Ombretta [1 ]
机构
[1] Univ Verona, Rheumatol Unit, Policlin GB Rossi, I-37134 Verona, Italy
[2] Univ Verona, Nephrol Unit, Verona, Italy
[3] ASST Nord Milano Cinisello Balsamo, Osped Bassini, Dept Nephrol & Dialysis, Milan, Italy
关键词
Kidney transplant recipients; Denosumab; Indices of bone quality; DXA; TBS; 3D-DXA; MINERAL DENSITY; POSTMENOPAUSAL WOMEN; FRACTURE RISK; OSTEOPOROSIS; DISEASE; CKD; UPDATE; EPIDEMIOLOGY; MANAGEMENT; TURNOVER;
D O I
10.1007/s00223-025-01349-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Kidney transplant recipients (KTRs) have an elevated fracture risk. While dual-energy X-ray absorptiometry (DXA) is commonly used to assess areal bone mineral density (aBMD), it does not capture all aspects of bone quality. We investigated the long-term effects on bone DXA-derived indices of bone quality in KTRs treated with denosumab and untreated with denosumab. This is a retrospective study, including KTRs treated with denosumab and untreated age and sex-matched KTR controls. DXA-derived parameters, including trabecular bone score (TBS) and 3D-DXA parameters, were measured at the lumbar spine and femur at baseline and after four years. Hierarchical linear models were used to assess the between-group effect of treatment over time, also adjusting for site-specific aBMDs. We enrolled 23 KTRs treated with denosumab and 23 KTR denosumab-untreated KTRs. Significant between-group differences over time in favor of the denosumab group were observed for TBS (0.843, 95%CI 0.439; 1.248,p < 0.001), trabecular volumetric BMD at the total hip (Tb.vBMD TH) (13.492, 95%CI 1.707; 25.278, p = 0.003), cortical volumetric BMD at the femoral neck (Ct.vBMD FN) (28.766, 95%CI 8.373; 49.158, p = 0.008), cortical surface BMD at the total hip (c.sBMD TH) (10.507, 95%CI 4.140; 16.873,p = 0.002), cortical surface at the femoral neck (c.sBMD FN) (8.795, 95%CI 2.818; 14.771, p = 0.006), and cortical thickness at the total hip (Ct.th.TH) (0.075, 95%CI 0.020; 0.130, p = 0.010). After adjusting for BMD, the differences on TBS and Ct.vBMD FN and c.sBMD FN remained significant. Denosumab treatment in KTRs was associated with better outcomes in terms of bone quality and geometry parameters, independent of changes in aBMD.
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页数:11
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  • [1] Kovesdy C.P., Epidemiology of chronic kidney disease: an update 2022, Kidney Int Suppl, 12, pp. 7-11, (2011)
  • [2] Disease K., Improving global outcomes (KDIGO) CKD-MBD update work group (2017) KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD), Kidney Int Suppl, 7, pp. 1-59, (2011)
  • [3] Aguilar A., Gifre L., Urena-Torres P., Et al., Pathophysiology of bone disease in chronic kidney disease: from basics to renal osteodystrophy and osteoporosis, Front Physiol, 14, (2023)
  • [4] Nair S.S., Lenihan C.R., Montez-Rath M.E., Et al., Temporal trends in the incidence, treatment and outcomes of hip fracture after first kidney transplantation in the United States, Am J Transplant, 14, pp. 943-951, (2014)
  • [5] Duarte M.P., Ribeiro H.S., Neri S.G.R., Et al., Prevalence of low bone mineral density (T-score ≤ - 2.5) in the whole spectrum of chronic kidney disease: a systematic review and meta-analysis, Osteoporos Int, 34, pp. 467-477, (2023)
  • [6] Bover J., Bailone L., Lopez-Baez V., Et al., Osteoporosis, bone mineral density and CKD-MBD: treatment considerations, J Nephrol, 30, pp. 677-687, (2017)
  • [7] Iimori S., Mori Y., Akita W., Et al., Diagnostic usefulness of bone mineral density and biochemical markers of bone turnover in predicting fracture in CKD stage 5D patients–a single-center cohort study, Nephrol Dial Transplant, 27, pp. 345-351, (2012)
  • [8] Bucur R.C., Panjwani D.D., Turner L., Et al., Low bone mineral density and fractures in stages 3–5 CKD: an updated systematic review and meta-analysis, Osteoporos Int, 26, pp. 449-458, (2015)
  • [9] Siris E.S., Miller P.D., Barrett-Connor E., Et al., Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the national osteoporosis risk assessment, JAMA, 286, pp. 2815-2822, (2001)
  • [10] Binkley N., Morin S.N., Martineau P., Et al., Frequency of normal bone measurement in postmenopausal women with fracture: a registry-based cohort study, Osteoporos Int, 31, pp. 2337-2344, (2020)