NUTRITIONAL OVERVIEW FOR PREVENTION OF OSTEOPOROSIS IN KIDNEY TRANPLANT RECIPIENTS
Main Article Content
Abstract
Osteoporosis is a common condition in post-kidney transplant patients due to various causes. This condition progresses silently over an extended period and can lead to serious consequences such as fractures, reduced quality of life, and exacerbation of underlying diseases. Therefore, early monitoring, prevention, and treatment of this condition are crucial. Nutrition is a safe and essential supportive measure for these patients. However, it remains a relatively new area with no unified recommendations for post-kidney transplant patients. In this article, we summarize all aspects of nutritional supplementation related to osteoporosis, aiming to support the selection and consideration of the most appropriate and comprehensive nutritional strategies to minimize the impact of bone-related disorders on post-kidney transplant patients.
Keywords
osteoporosis, kidney transplant
Article Details
References
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22. Courbebaisse M, Thervet E, Souberbielle JC, et al. Effects of vitamin D supplementation on the calcium–phosphate balance in renal transplant patients. Kidney International. 2009;75(6):646-651. doi:10.1038/ki.2008.549
23. Wissing KM, Broeders N, Moreno-Reyes R, Gervy C, Stallenberg B, Abramowicz D. A Controlled Study of Vitamin D3 to Prevent Bone Loss in Renal-Transplant Patients Receiving Low Doses of Steroids. Transplantation. 2005;79(1):108. doi:10.1097/01.TP.0000149322.70295.A5
24. Bhoi S, Pal A, Das A. Effect of Calcium and Vitamin D on Bone Health among Kidney Transplant Recipients in a Prospective Randomized Controlled Trial. Indian Journal of Transplantation. 2024;18(3):282. doi:10.4103/ijot.ijot_141_23
25. Heaney RP. Vitamin D and calcium interactions: functional outcomes. Am J Clin Nutr. 2008;88(2):541S-544S. doi: 10.1093/ajcn/88.2.541S.
26. Chevarria J, Sexton DJ, Murray SL, et al. Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival. Clin Kidney J. 2020;14(4):1106-1113. doi:10.1093/ckj/sfaa061
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28. Ahn CB, Je JY. Bone health-promoting bioactive peptides. Journal of Food Biochemistry. 2019;43(1):e12529. doi:10.1111/jfbc.12529
29. Sun S, Liu F, Liu G, et al. Effects of casein phosphopeptides on calcium absorption and metabolism bioactivity in vitro and in vivo. Food Funct. 2018;9(10):5220-5229. doi:10.1039/C8FO00401C
30. Cardoso DF, Marques EA, Leal DV, et al. Impact of physical activity and exercise on bone health in patients with chronic kidney disease: a systematic review of observational and experimental studies. BMC Nephrol. 2020;21:334. doi:10.1186/s12882-020-01999-z
31. Eatemadololama A, Karimi MT, Rahnama N, Rasolzadegan MH. Resistance exercise training restores bone mineral density in renal transplant recipients. Clin Cases Miner Bone Metab. 2017;14(2):157-160. doi:10.11138/ccmbm/2017.14.1.157
32. Roseanne E. Billany, Nicolette C. Bishop, Ellen M. Castle, Matthew P. M. Graham-Brown, Sharlene A. Greenwood, Courtney J. Lightfoot & Thomas J. Wilkinson. (2025) Physical activity interventions in adult kidney transplant recipients: an updated systematic review and meta-analysis of randomized controlled trials. Renal Failure 47:1. doi: 10.1080/10833196.2021.2002641
33. Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH and De Smet S (2024) Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 37:12448. doi: 10.3389/ti.2024.12448
2. Lewiecki EM. Osteoporosis: Clinical Evaluation. In: Feingold KR, Ahmed SF, Anawalt B, et al., eds. Endotext. MDText.com, Inc.; 2000. Accessed August 12, 2025. http://www.ncbi.nlm.nih.gov/books/NBK279049/
3. Park WY, Han S, Choi BS, et al. Progression of Osteoporosis After Kidney Transplantation in Patients With End-Stage Renal Disease. Transplant Proc. 2017;49(5):1033-1037. doi:10.1016/j.transproceed.2017.03.038
4. Kim KJ, Ha J, Kim SW, et al. Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations. Endocrinol Metab (Seoul). 2024;39(2):267-282. doi:10.3803/EnM.2024.1939
5. Alshayeb HM, Josephson MA, Sprague SM. CKD–Mineral and Bone Disorder Management in Kidney Transplant Recipients. American Journal of Kidney Diseases. 2013;61(2):310-325. doi:10.1053/j.ajkd.2012.07.022
6. Kurnool S, Shah N, Ekanayake P. Treatment of osteoporosis in the solid organ transplant recipient: an organ-based approach. Ther Adv Endocrinol Metab. 2025;16:20420188251347351. doi:10.1177/20420188251347351
7. Bộ Y tế. Cổng thông tin. Bệnh suy thận ngày càng gia tăng và trẻ hóa. Truy cập ngày 3/8/ 2025. tại https://moh.gov.vn/home?p_p_id=101&p_p_lifecycle=0&p_p_state=maximized&p_p_mode=view&_101_struts_action=%2Fasset_publisher%2Fview_content&_101_type=content&_101_urlTitle=benh-suy-than-ngay-cang-gia-tang-va-tre-hoa
8. NHS Blood and Transplant. Benefits and risks of a kidney transplant. Organ transplantation. Accessed August 3, 2025. https://www.nhsbt.nhs.uk/organ-transplantation/kidney/benefits-and-risks-of-a-kidney-transplant/
9. Atkinson SA, Ward WE. Clinical nutrition: 2. The role of nutrition in the prevention and treatment of adult osteoporosis. CMAJ. 2001;165(11):1511-1514.
10. Teh JW, Mac Gearailt C, Lappin DWP. Post-Transplant Bone Disease in Kidney Transplant Recipients: Diagnosis and Management. International Journal of Molecular Sciences. 2024;25(3):1859. doi:10.3390/ijms25031859
11. Zhang R, Chouhan KK. Metabolic bone diseases in kidney transplant recipients. World J Nephrol. 2012;1(5):127-133. doi:10.5527/wjn.v1.i5.127
12. Bệnh xương sau ghép | Quỹ Thận Quốc gia. Accessed August 12, 2025. https://www.kidney.org/post-transplant-bone-disease
13. Molnar MZ, Naser MS, Rhee CM, Kalantar-Zadeh K, Bunnapradist S. Bone and mineral disorders after kidney transplantation: therapeutic strategies. Transplant Rev (Orlando). 2014;28(2):56-62. doi:10.1016/j.trre.2013.12.003
14. Sánchez-Borrego R, Schacky C von, Osorio MJA, et al. Recommendations of the Spanish Menopause Society on the consumption of omega-3 polyunsaturated fatty acids by postmenopausal women. Maturitas. 2017;103:71-77. doi:10.1016/j.maturitas.2017.06.028
15. Botelho J, Machado V, Proença L, Delgado AS, Mendes JJ. Vitamin D Deficiency and Oral Health: A Comprehensive Review. Nutrients. 2020;12(5):1471. doi:10.3390/nu12051471.
16. Yu RW, Faull RJ, Coates PTH, Coates PS. Calcium supplements lower bone resorption after renal transplant. Clinical Transplantation. 2012;26(2):292-299. doi:10.1111/j.1399-0012.2011.01487.x
17. Karpouzos A, Diamantis E, Farmaki P, Savvanis S, Troupis T. Nutritional Aspects of Bone Health and Fracture Healing. J Osteoporos. 2017;2017:4218472. doi:10.1155/2017/4218472
18. Price CT, Langford JR, Liporace FA. Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet. Open Orthop J. 2012;6:143-149. doi:10.2174/1874325001206010143.
19. Sunyecz J. The use of calcium and vitamin D in the management of osteoporosis. TCRM. 2008;4(4):827-836. doi:10.2147/TCRM.S3552
20. Heaney RP. Calcium intake and disease prevention. Arq Bras Endocrinol Metabol. 2006;50(4):685-693. doi:10.1590/s0004-27302006000400014
21. Benaboud S, Urien S, Thervet E, et al. Determination of optimal cholecalciferol treatment in renal transplant recipients using a population pharmacokinetic approach. Eur J Clin Pharmacol. 2013;69(3):499-506. doi:10.1007/s00228-012-1378-3
22. Courbebaisse M, Thervet E, Souberbielle JC, et al. Effects of vitamin D supplementation on the calcium–phosphate balance in renal transplant patients. Kidney International. 2009;75(6):646-651. doi:10.1038/ki.2008.549
23. Wissing KM, Broeders N, Moreno-Reyes R, Gervy C, Stallenberg B, Abramowicz D. A Controlled Study of Vitamin D3 to Prevent Bone Loss in Renal-Transplant Patients Receiving Low Doses of Steroids. Transplantation. 2005;79(1):108. doi:10.1097/01.TP.0000149322.70295.A5
24. Bhoi S, Pal A, Das A. Effect of Calcium and Vitamin D on Bone Health among Kidney Transplant Recipients in a Prospective Randomized Controlled Trial. Indian Journal of Transplantation. 2024;18(3):282. doi:10.4103/ijot.ijot_141_23
25. Heaney RP. Vitamin D and calcium interactions: functional outcomes. Am J Clin Nutr. 2008;88(2):541S-544S. doi: 10.1093/ajcn/88.2.541S.
26. Chevarria J, Sexton DJ, Murray SL, et al. Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival. Clin Kidney J. 2020;14(4):1106-1113. doi:10.1093/ckj/sfaa061
27. Alanna JM, Arminda FK, Jonhon CC, US. Department of Agriculture. Phosphorus Intake of Americans, WWEIA, NHNAES 2011-12. Accessed July 31, 2025. https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/DBrief/15_Phosphorus_intake_1112.pdf
28. Ahn CB, Je JY. Bone health-promoting bioactive peptides. Journal of Food Biochemistry. 2019;43(1):e12529. doi:10.1111/jfbc.12529
29. Sun S, Liu F, Liu G, et al. Effects of casein phosphopeptides on calcium absorption and metabolism bioactivity in vitro and in vivo. Food Funct. 2018;9(10):5220-5229. doi:10.1039/C8FO00401C
30. Cardoso DF, Marques EA, Leal DV, et al. Impact of physical activity and exercise on bone health in patients with chronic kidney disease: a systematic review of observational and experimental studies. BMC Nephrol. 2020;21:334. doi:10.1186/s12882-020-01999-z
31. Eatemadololama A, Karimi MT, Rahnama N, Rasolzadegan MH. Resistance exercise training restores bone mineral density in renal transplant recipients. Clin Cases Miner Bone Metab. 2017;14(2):157-160. doi:10.11138/ccmbm/2017.14.1.157
32. Roseanne E. Billany, Nicolette C. Bishop, Ellen M. Castle, Matthew P. M. Graham-Brown, Sharlene A. Greenwood, Courtney J. Lightfoot & Thomas J. Wilkinson. (2025) Physical activity interventions in adult kidney transplant recipients: an updated systematic review and meta-analysis of randomized controlled trials. Renal Failure 47:1. doi: 10.1080/10833196.2021.2002641
33. Stylemans D, Vandecruys M, Leunis S, Engelborghs S, Gargioli D, Monbaliu D, Cornelissen V, Van Craenenbroeck AH and De Smet S (2024) Physical Exercise After Solid Organ Transplantation: A Cautionary Tale. Transpl Int 37:12448. doi: 10.3389/ti.2024.12448