B151 - A Single-Center Retrospective Study on the Role of Denosumab in Mineral and Bone Metabolism Disorder After Kidney Transplantation

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Author Block: Z. Wen, L. Sun, S. Fei, H. Chen, R. Tan, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
*Purpose: Mineral and bone disorders are highly prevalent and significantly impact both physical and mental health in uremic patients following kidney transplantation. Denosumab is widely used for the treatment of postmenopausal osteoporosis, but its application in kidney transplant recipients remains limited. This study aims to preliminarily investigate the efficacy and safety of denosumab on mineral and bone disorders in kidney transplant recipients.
*Methods: This study included kidney transplant recipients diagnosed with osteoporosis by Dual-energy X-ray Absorptiometry (DXA) at our center. The subjects received subcutaneous denosumab 60 mg every six months and were followed up for 12 months. Data on changes in bone metabolism markers were systematically collected before treatment, and at 1 month, 6 months, and 12 months after treatment initiation. These markers included serum calcium, serum phosphorus, 25-hydroxyvitamin D (25(OH)vitD), intact parathyroid hormone (iPTH), bone-specific alkaline phosphatase (BALP), osteocalcin (OC), calcitonin, serum cardiac troponin T (cTnT), and the concentrations of N-terminal telopeptide of type I collagen (NTx) and C-terminal telopeptide of type I collagen (CTx).
*Results: A total of 52 kidney transplant recipients were included in this study. After 12 months of denosumab treatment compared to baseline, the levels of the following parameters decreased: serum phosphorus (1.26 ± 0.54 vs 0.93 ± 0.20 mmol/L, P < 0.01), serum OC (75.23 ± 86.89 vs 19.37 ± 15.27 ng/mL, P < 0.001), BALP (30.79 ± 25.25 vs 17.41 ± 11.69 U/L, P < 0.01), calcitonin (28.32 ± 44.45 vs 3.42 ± 10.79 pg/mL, P < 0.001), NTx (266.98 ± 342.02 vs 64.80 ± 48.27 ng/mL, P < 0.001), and CTx (1.71 ± 1.35 vs 0.57 ± 0.49 ng/mL, P < 0.001).No significant differences were observed after 12 months of denosumab treatment compared to baseline in the levels of serum calcium (2.42 ± 0.20 vs 2.44 ± 0.15 mmol/L, P = 0.521), 25-hydroxyvitamin D (41.90 ± 18.74 vs 46.76 ± 18.73 nmol/L, P = 0.208), serum cardiac troponin T (24.35 ± 21.53 vs 16.55 ± 14.28 μg/L, P = 0.310), and serum iPTH (181.25 ± 179.38 vs 169.23 ± 158.77 pg/mL, P = 0.730).
*Conclusions: The denosumab treatment regimen can reduce bone turnover marker levels in kidney transplant recipients and demonstrates a favorable safety profile. The long-term effects of denosumab on bone metabolism and bone mineral density after kidney transplantation warrant further investigation.