Sunday, October 24, 2010
FGF-23 and PTH and Bone Disease post transplant
BMD loss is common complication following kidney transplantation.
Few points to take home from a recent paper published in CJASN 2010, October edition.
1. The bone loss is accelerated in the post transplant period- why? Steroids and perhaps CNI worsen the rate.
2. Other risk factors are pre existing renal disease, hypogonadism, and metabolic acidosis.
3. 90% of post transplant patients have hypophosphatemia( CNI related and or tertiary hyperparathyroidism)
4. Renal phosphate wasting has bad effects on bone
5. The renal phosphate wasting in part might be caused by elevated FGF23 levels or phosphatonin hormone.
6. PTH levels don't return completely to normal in most transplant patients post transplant
7. FGF 23 levels usually return to normal after one year post transplant
8. A recent study found that a high FGF23 level and low pth at time of transplant are the highest risk of developing bone disease post transplant
9. The most common bone biopsy finding post transplant is adynamic bone disease.
Image source: clipartheaven.com
- ► 2020 (19)
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- ► 2011 (370)
- Nephsap review: AKI and ICU Nephrology
- Minimal Change Disease
- IN THE NEWS- CALMAG TRIAL
- TOPIC DISCUSSION: Management of DKA in hemodialysi...
- Nephrology Fellows do better with online training!
- IN THE NEWS- Barbershop BP management is better th...
- Outcomes of kidney transplantation from HCV positi...
- IN THE NEWS- Permeability Factor and FSGS
- Salivary Prograf levels
- U 002 Nierentransplantation / kidney transplant
- TOPIC DISCUSSION: Green Urine
- FGF-23 and PTH and Bone Disease post transplant
- IN THE NEWS- Bilirubin might be protective
- Aspergilloma in the transplant kidney
- Racial Disparities in CKD, a presentation
- CONSULT ROUNDS: Page Kidney
- Renal Fellow Network: Pancreas transplant pearls
- TOPIC DISCUSSION: Different ARBS
- TOPIC DISCUSSION: Urinary Diversions
- Wait list and desensitization?
- CLINICAL CASE 27, ANSWERS and SUMMARY
- Sirolimus and Male Fertility
- IN THE NEWS:- Tiger on Dialysis
- IN THE NEWS:- Cardiorenal syndrome or renocardiac ...
- NEJM Case
- CONSULT ROUNDS: renal disease
- TOPIC DISCUSSION: Chronic Hyponatremia
- Quiz 7 Answers
- New Transplant Information website
- CONSULT ROUNDS: Free water excretion
- TOPIC DISCUSSION: SECONDARY VS PRIMARY FSGS
- TOPIC DISCUSSION: Maintenance of Metabolic Alkalosis
- REJECTION and TOLERANCE
- KIDNEY WEBSITES IN my languages!
- Renal Fellow Network: Key to angiotensin formation...
- JOURNAL CLUB: AASK TRIAL 2010
- TOPIC DISCUSSION: An uncommon consult:-OHSS!
- IN THE NEWS- Nephrology Workfore
- Basic concepts in Immunology
- Role Playing exercise in Transplant Education
- TOPIC DISCUSSION
- CLINICAL CASE 26 , ANSWER and SUMMARY
- ▼ October (42)