Author(s): Birne,Rita ; Adragão,Teresa ; Ferreira,Aníbal ; Dickson,Jorge ; Silva,Rui ; Casqueiro,Ana ; Oliveira,Regina ; Martins,Ana Rita ; Torres,João ; Matias,Patrícia ; Branco,Patrícia ; Jorge,Cristina ; Weigert,André ; Bruges,Margarida ; Machado,Domingos
Date: 2014
Origin: SciELO Portugal
Subject(s): Bone biopsy; cinacalcet; ckd-mbd; hypercalcaemia; kidney transplantation; osteoporosis
A 50-year-old post-menopausal recipient of a kidney allograft with bone pain, osteoporosis, persistent hypercalcaemia and elevated parathormone (PTH) levels, despite a satisfactory graft function, was treated with bisphosphonates and cinacalcet starting, respectively, 5 and 6 months after renal transplantation (RT). Sixteen months after treatment, there was improvement of bone mineral density (BMD) measured by dualenergy X-ray absorptiometry (DEXA). A bone biopsy was taken, unveiling a surprising and worrisome result. Post-RT bone disease is different from classic CKD-MBD and should be managed distinctly, including, in some difficult cases, an invasive evaluation through the performance of a bone biopsy, as suggested in the KDIGO guidelines.
