{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:18:04Z","timestamp":1782908284356,"version":"3.54.5"},"reference-count":34,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T00:00:00Z","timestamp":1492732800000},"content-version":"vor","delay-in-days":51,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The management of post\u2010transplantation bone disease is a complex problem that remains under\u2010appreciated in clinical practice. In these patients, pre\u2010existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin\u2010inhibitors), variable post\u2010transplantation renal allograft function and post\u2010transplantation diabetes mellitus. The treatment of post\u2010transplantation bone loss should begin pre\u2010transplantation. All patients active on transplant waiting lists should be screened for bone disease. Patients should also be encouraged to take preventative measures against osteoporosis such as regular weight\u2010bearing exercise, smoking cessation and reducing alcohol consumption. Biochemical abnormalities of disordered mineral metabolism should be corrected prior to transplantation wherever possible, and because these abnormalities commonly persist, post transplant hypophosphatemia, persistent hyperparathyroidism and low vitamin D levels should be regularly monitored and treated. Bone loss is greatest in the first 6\u201312\u00a0months post\u2010transplantation, during which period any intervention is likely to be of greatest benefit. There is strong evidence that bisphosphonates prevent post\u2010transplantation bone loss; however, data are lacking that this clearly extends to a reduction in fracture incidence. Denosumab is a potential alternative to vitamin D receptor agonists and bisphosphonates in reducing post\u2010transplantation bone loss; however, further studies are needed to demonstrate its safety in patients with a significantly reduced estimated glomerular filtration rate. Clinical judgement remains the cornerstone of this complex clinical problem, providing a strong rationale for the formation of combined endocrinology and nephrology clinics to treat patients with Chronic Kidney Disease\u2010Mineral and Bone Disorder, before and after transplantation.<\/jats:p>","DOI":"10.1111\/nep.13028","type":"journal-article","created":{"date-parts":[[2017,4,21]],"date-time":"2017-04-21T05:40:22Z","timestamp":1492753222000},"page":"65-69","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Management of mineral and bone disorders in renal transplant recipients"],"prefix":"10.1111","volume":"22","author":[{"given":"Matthew J","family":"Damasiewicz","sequence":"first","affiliation":[{"name":"Department of Nephrology Monash Health  Melbourne Australia"},{"name":"Department of Medicine Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R","family":"Ebeling","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Monash Health  Melbourne Australia"},{"name":"Department of Medicine Monash University  Melbourne Australia"},{"name":"School of Clinical Sciences at Monash Health Monash University  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,21]]},"reference":[{"key":"e_1_2_3_2_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease\u2013mineral and bone disorder (CKD\u2013MBD)","volume":"76","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD\u2013MBD Work Group","year":"2009","journal-title":"Kidney Int."},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0205"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.07.022"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.23.3014"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00938.x"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2000.8289"},{"issue":"3","key":"e_1_2_3_8_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the care of kidney transplant recipients","volume":"9","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group","year":"2009","journal-title":"Am. 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