Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?

Answer from: at Community Practice

In the absence of good evidence to guide us on what to do in this instance (or good evidence to support different treatments for osteopenia/osteoporosis post-transplant), I would focus on maintaining adequate 25-OH vitamin D levels, keep PTH in a range that I would be comfortable with (arbitrarily &...

Answer from: at Academic Institution

I agree with Dr. @Song. Bone metabolism in renal transplant is woefully shy of good data. My opinion is to monitor Vitamin D levels, provide appropriate supplementation, and monitor PTH levels, using cinacalcet as needed. My target level for PTH is 1-2x the upper limit of normal, also based on limit...

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Would you order a repeat DEXA scan 1 year later for a kidney transplant patient who had an initial DEXA scan within the first 6 months post-transplant showing osteopenia but no history of fractures, and who has been stable on glucocorticoid-free immunosuppressive therapy?

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