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Randomized Controlled Trial
. 2012 Aug;23(8):1426-37.
doi: 10.1681/ASN.2011060623. Epub 2012 Jul 12.

Effect of risedronate on bone in renal transplant recipients

Maria Coco  1 , James Pullman, Hillel W Cohen, Sally Lee, Craig Shapiro, Clemencia Solorzano, Stuart Greenstein, Daniel Glicklich
Affiliations
Randomized Controlled Trial

Effect of risedronate on bone in renal transplant recipients

Maria Coco et al. J Am Soc Nephrol. 2012 Aug.

Abstract

Bisphosphonates may prevent or treat the bone loss promoted by the immunosuppressive regimens used in renal transplantation. Risedronate is a commonly used third-generation amino-bisphosphonate, but little is known about its effects on the bone health of renal transplant recipients. We randomly assigned 42 new living-donor kidney recipients to either 35 mg of risedronate weekly or placebo for 12 months. We obtained bone biopsies at the time of renal transplant and after 12 months of protocol treatment. Treatment with risedronate did not affect bone mineral density (BMD) in the overall cohort. In subgroup analyses, it tended to preserve BMD in female participants but did not significantly affect the BMD of male participants. Risedronate did associate with increased osteoid volume and trabecular thickness in male participants, however. There was no evidence for the development of adynamic bone disease. In summary, further study is needed before the use of prophylactic bisphosphonates to attenuate bone loss can be recommended in renal transplant recipients.

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Figures

Figure 1.
Figure 1.
Participant randomization. F, female; M, male.
Figure 2.
Figure 2.
In the risedronate arm, female participants preserved more BMD than male participants at the lumbar spine (LSS6, P=0.04) and hip (hip6, P=0.004) at 6 months. RIS, risedronate; CON, control.
Figure 3.
Figure 3.
Distribution of bone histomorphometry at baseline and 12 months in the risedronate and control study groups.
See this image and copyright information in PMC

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