Management of severe osteoporosis.

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Abstract

[Indexed for MEDLINE] 14. Medicina (Kaunas). 2020 Jun 19;56(6):302. doi: 10.3390/medicina56060302. Risk Factors and Management of Osteoporosis Post-Transplant. Kovvuru K(1), Kanduri SR(2), Vaitla P(2), Marathi R(3), Gosi S(4), Garcia Anton DF(2), Cabeza Rivera FH(2), Garla V(5). Author information: (1)Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39156, USA. (2)Division of Nephrology, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39156, USA. (3)Division of Hospital Medicine, Department of Medicine, University of Mississippi Medical Center, Jackson, MS 39156, USA. (4)Department of Hospital Medicine, Banner Thunderbird Medical Center, Glenadale, AZ 85306, USA. (5)Department of Internal Medicine and Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, MS 39156, USA. Bone and mineral disorders are common after organ transplantation. Osteoporosis post transplantation is associated with increased morbidity and mortality. Pathogenesis of bone disorders in this particular sub set of the population is complicated by multiple co-existing factors like preexisting bone disease, Vitamin D deficiency and parathyroid dysfunction. Risk factors include post-transplant immobilization, steroid usage, diabetes mellitus, low body mass index, older age, female sex, smoking, alcohol consumption and a sedentary lifestyle. Immunosuppressive medications post-transplant have a negative impact on outcomes, and further aggravate osteoporotic risk. Management is complex and challenging due to the sub-optimal sensitivity and specificity of non-invasive diagnostic tests, and the underutilization of bone biopsy. In this review, we summarize the prevalence, pathophysiology, diagnostic tests and management of osteoporosis in solid organ and hematopoietic stem cell transplant recipients. DOI: 10.3390/medicina56060302 PMCID: PMC7353876