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Bone disease after renal transplantation

Thomas Nickolas, MD, MS
Sri G Yarlagadda, MD
L Darryl Quarles, MD
Kathryn Diemer, MD
Elizabeth Shane, MD
Section Editor
Daniel C Brennan, MD, FACP
Deputy Editor
Albert Q Lam, MD


The major bone diseases that affect renal transplant recipients are osteoporosis and osteonecrosis (avascular necrosis), both of which cause significant long-term morbidity [1]. Osteoporosis increases the risk of fractures [1,2].

Because of their longstanding history of chronic kidney disease (CKD), renal transplant recipients are also vulnerable to persistent hyperparathyroidism and the mineral and bone disorders of chronic kidney disease (CKD-MBD). The evaluation and treatment of osteoporosis are made more complex because of CKD-MBD.

This topic reviews the monitoring, diagnosis, and treatment of osteoporosis and osteonecrosis among renal transplant recipients.

Persistent hyperparathyroidism and other disorders of mineral metabolism are discussed elsewhere. (See "Persistent hyperparathyroidism after renal transplantation".)

Other bone diseases that affect renal transplant patients, including dialysis-related amyloidosis and renal osteodystrophy associated with aluminum toxicity, are far less common and are discussed elsewhere. (See "Dialysis-related amyloidosis", section on 'Overview' and "Aluminum toxicity in chronic kidney disease".)

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Literature review current through: Nov 2017. | This topic last updated: Jun 23, 2017.
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