Amaç: Renal transplant alıcılarında kemik mineral yoğunluğunun (KMY) azalma riski vardır. Osteoporoz ve osteoporoza bağlı kırıklar ciddi
komplikasyonlara neden olabilirler. Bu çalışmada denosumab ve bifosfonatın etkinliğini ve güvenilirliğini değerlendirmeyi amaçladık.
Yöntemler: İstanbul Üniversitesi-Cerrahpaşa Nefroloji Bilim Dalı’nda takipli osteoporozu olan 32 renal transplant alıcısı retrospektif
olarak incelendi. Hastalardan 10'u denosumab ile 22'si bifosfonat ile tedavi alıyordu. Hastaların transplantasyondan sonraki süreleri,
kümülatif steroid dozları, başlangıç ve birinci yıl kalsiyum, fosfor, paratiroid hormon ve glomerüler filtrasyon hızları (GFR) karşılaştırıldı.
Başlangıç ve birinci yıl femur ve lomber KMY değerleri grup içinde ve gruplararası karşılaştırıldı.
Bulgular: Denosumab tedavi kolunda başlangıç femur KMY değerleri anlamlı olarak daha düşük saptandı, ancak lomber KMY değerleri
arasında anlamlı bir fark saptanmadı. Tedavinin ilk yılında her iki tedavi kolunda lomber KMY değerlerinde anlamlı bir artış saptanırken
Objective: Kidney transplant recipients are at risk of losing bone mineral density. Osteoporosis and fractures cause serious complications
in renal transplant recipients. We aimed to evaluate the efficacy and safety of bisphosphonate and denosumab treatments.
Methods: Thirty-two renal transplant patients with osteoporosis from Division of Nephrology of İstanbul University-Cerrahpaşa
were retrospectively evaluated. Ten patients were treated with denosumab, 22 patients were treated with bisphosphonate. Time elapsed
after transplantation, cumulative steroid doses, baseline and first-year calcium, phosphorus, parathyroid hormone, and the glomerular filtration rate were compared. The initial and first-year femur and lumbar bone mineral densities were compared for both groups
separately.
Results: The baseline femur bone mineral density was significantly lower in the denosumab arm, but there was no significant difference
between the initial lumbar bone mineral densities between groups. There was a significant increase in lumbar bone mineral density for
both the denosumab and bisphosphonate arms in the first year of treatment. For both groups, there was no significant increase in femur
bone mineral density in the first year of treatment. The time elapsed after transplantation and cumulative steroid dose were higher in the
denosumab arm. Glomerular filtration rate levels of the denosumab arm were lower compared to bisphosphonate arm. Hypocalcemia
associated with antiresorptive agent was not found in the treatment arms. In the first year of treatment, calcium levels were significantly
lower in the denosumab treatment arm.
Conclusion: Denosumab is an effective treatment option, especially in renal transplant patients with a low glomerular filtration rate.
