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Altered hormonal status, including sex hormones and parathyroid hormone (PTH), a deficit of 1,25(OH)<jats:sub>2<\/jats:sub>\u00a0vitamin\u00a0D<jats:sub>3<\/jats:sub>(calcitriol), immunosuppressive therapy and post\u2010operative immobilization contribute to a progressive loss of bone density and structure. The decrease of bone mass is particularly prominent during the first 6\u00a0months after kidney transplantation and is associated with an increased number of fractures, both compared with the normal population as well as with dialysis patients. At particular risk are patients with a history of diabetes, long duration of haemodialysis and post\u2010menopausal women.<\/jats:p><jats:p>To prevent post\u2010transplant bone loss prescription of steroids should be minimized and withdrawn as early as possible. Additional intake of \u03b1\u2010calcidol [25(OH)\u00a0vitamin\u00a0D<jats:sub>3<\/jats:sub>] or calcitriol, despite normal serum levels, reduces persistent hyperparathyroidism after kidney transplantation, improves intestinal calcium absorption and activates osteoblasts. Inhibition of osteoclasts by biphosphonate therapy seems to effectively reverse bone loss during the early and late course of kidney transplantation. However, as the majority of transplant recipients have a low\u2010turnover bone disease, inhibition of osteoclasts, through which bone turnover is impaired, might further reduce osteoblast activity and promote osteoid synthesis.<\/jats:p><jats:p>Most investigations were small\u2010scale studies with 10\u2013100\u00a0participants and a follow up of only 12\u00a0months. This makes conclusions on the effect of any intervention on the fracture rate impossible. Larger, randomized multicentre studies investigating bone\u2010sparing therapy on hard end points are therefore advocated.<\/jats:p>","DOI":"10.1111\/j.1365-2362.2006.01662.x","type":"journal-article","created":{"date-parts":[[2006,7,12]],"date-time":"2006-07-12T07:44:24Z","timestamp":1152690264000},"page":"63-75","source":"Crossref","is-referenced-by-count":45,"title":["Effect of kidney transplantation on bone"],"prefix":"10.1111","volume":"36","author":[{"given":"K.","family":"Kodras","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Haas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2006,7,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00306.x"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000149322.70295.A5"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000133513.29923.44"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.00432.x"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000137937.44703.42"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00816.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200301150-00009"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000093255.56474.B4"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1389-0"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000016082.70875.36"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/17.7.1318"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1432-2277.2002.tb00133.x"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200202270-00024"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(00)02475-1"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.V1271530"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(00)01898-4"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.t01-1-00890.x"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.00341.x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.83.11.3795"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(98)00060-8"},{"key":"e_1_2_6_22_2","first-page":"3485","article-title":"Efficiency of preventive treatment of glucocorticoid\u2010induced osteoporosis with 25\u2010hydroxyvitamin D3 and calcium in kidney transplant patients","volume":"28","author":"Talalaj M","year":"1996","journal-title":"Transplant Proc"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090102"},{"key":"e_1_2_6_24_2","first-page":"166","article-title":"Changes in total body bone mineral content and regional bone mineral density in renal patients following renal transplantation","volume":"18","author":"Kwan JTC","year":"1992","journal-title":"Miner Electrolyte Metab"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199108223250804"},{"key":"e_1_2_6_26_2","first-page":"67","article-title":"Calcium metabolism and hyperparathyroidism after renal transplantation","volume":"52","author":"Cundy T","year":"1983","journal-title":"Q J Med"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0041-1345(00)01802-9"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00938.x"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000087092.53894.80"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(04)00955-2"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780391104"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1991.315"},{"issue":"3","key":"e_1_2_6_33_2","first-page":"S1","article-title":"K\/DOQI Clinical practice guidelines for bone metabolism and disease in chronic kidney disease","volume":"42","author":"National Kidney Foundation.","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1159\/000181455"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196812192792501"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5836.366-a"},{"key":"e_1_2_6_37_2","first-page":"385","article-title":"Metabolic bone disease in chronic renal failure II. 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