Incidence of Skeletal Complications in Renal Graft Recipients: Effect of Changes in Pharmacotherapy

Abstract

The purpose of this study was to examine whether the occurrence of skeletal complications of renal transplantation is affected by a reduction in the steroid dose and avoidance of hypophosphataemia after the operation. A group of 36 patients that had been given smaller steroid doses and where non-phosphate-binding antacid had been given to most of the patients with hypophosphataemia were compared with a group of 144 long-term survivors given the formerly used, higher dose of steroids, and also phosphate-binding antacid agents. The modification of the regimen did not reduce the incidence of spontaneous fractures but none of the patients developed osteonecrosis after this change (P < 0.1). Patients in the group receiving non-phosphate-binding antacids displayed a higher serum phosphorus level (P < 0.1). Our results suggest that the development of osteonecrosis after renal transplantation may be avoided by reducing the steroid dose and avoiding hypophosphataemia.