Association of 25-Hydroxyvitamin D and Bone Turnover Markers Levels With Bone Mineral Density Measurement in Renal Transplant Patients.

OBJECTIVES: Chronic kidney disease is associated with mineral and bone disorders, including abnormalities in calcium, phosphorus, parathyroid hormone, and vitamin D metabolism, as well as bone diseases like renal osteodystrophy. Although renal transplant can improve some bone mineral disorders, osteoporosis and altered bone metabolism remain important issues due to factors like corticosteroid use and persistent hyperparathyroidism. Bone biopsies are the gold standard for diagnosing bone disorders but are invasive, leading to the exploration of noninvasive methods such as bone turnover markers and bone mineral density measurements. In this study, we aimed to investigate whether there is a relationship between bone turnover markers and bone mineral densities measured by dual -energy X -ray absorptiometry.

MATERIALS AND METHODS: This study evaluated 121 renal transplant patients categorized as normal, with osteopenia, or with osteoporosis based on dual -energy X -ray absorptiometry measurements. Biochemical markers (parathyroid hormone, alkaline phosphatase, calcium, phosphorus, vitamin D, beta -CrossLaps, and osteocalcin ) were analyzed for their relationship with bone mineral density.

RESULTS: Osteoporosis was more common in women (34.09 % ) than in men (9.09 % ), likely because of postmenopausal hormonal changes. No significant correlation between bone mineral density and bone turnover markers was observed, and none of the biochemical markers demonstrated strong predictive value for osteoporosis.

CONCLUSIONS: Findings suggested that bone mineral density alone is insufficient to fully evaluate bone health, as bone turnover can vary significantly among individuals. A more comprehensive assessment combining bone mineral density, bone turnover markers, and clinical findings is necessary for a better understanding of bone health in renal transplant patients. However, the study's limitations, including a relatively small sample size, single -point measurements, and lack of follow -up, underscore the need for larger, longitudinal studies. Such studies are essential to better understand bone turnover dynamics and to develop optimized screening and treatment strategies for this patient population.