Trial reportJournal of the American Society of Nephrology : JASN2019
A Randomized Trial of Zoledronic Acid to Prevent Bone Loss in the First Year after Kidney Transplantation.
Trial report in Journal of the American Society of Nephrology : JASN, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Comparative efficacy and safety of anti-osteoporotic therapies for kidney transplant recipients: a systematic review and network meta-analysis.Frontiers in endocrinology · 2025Pooled it
- The effect of zoledronic acid on hip geometry in renal transplant recipients: a double-blind placebo-controlled randomized study.BMC nephrology · 2023Trial
- Cholecalciferol Supplementation Attenuates Bone Loss in Incident Kidney Transplant Recipients: A Prespecified Secondary Endpoint Analysis of a Randomized Controlled Trial.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Trial
- Predictive Power of Bone Turnover Biomarkers to Estimate Bone Mineral Density after Kidney Transplantation with or without Denosumab: A post hoc Analysis of the POSTOP Study.Kidney & blood pressure research · 2020Trial
- Bone Mineral Density Loss After Kidney Transplantation: Metabolic Determinants, Diagnostic Approaches, and Preventive Strategies.Kidney international reports · 2026Review
- Bone Turnover Markers, DXA and Mineral Metabolism in Long-Term Kidney Transplant Recipients: A Cross-Sectional Comparative Study.Journal of clinical medicine · 2026Article
- Management of bone health in adult solid organ transplant recipients: a multidisciplinary care pathway.Clinical transplantation and research · 2026Article
- Renal Outcomes and Dosage Considerations Associated with Bisphosphonate Use: A Systematic Review of Randomized Clinical Trials.Research square · 2026Article
- Uremia and parathyroid hormone have distinct effects on bone protein and gene expression.Kidney international · 2026Article
- Bone from Healthy Individuals and Patients with CKD Expresses the Sodium-Glucose Co-transporter-2 (SGLT2).Calcified tissue international · 2026Article
- Treatment of osteoporosis in the solid organ transplant recipient: an organ-based approach.Therapeutic advances in endocrinology and metabolism · 2025Review
- Article
- Hip geometry and strength remain stable the first year after kidney transplantation-an ibandronate/placeboJBMR plus · 2024Article
- The Relationship between Sclerostin and Kidney Transplantation Mineral Bone Disorders: A Molecule of Controversies.Calcified tissue international · 2024Review
- Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations.Endocrinology and metabolism (Seoul, Korea) · 2024Review
- Biochemical Clusters as Substitutes of Bone Biopsies in Kidney Transplant Patients.Calcified tissue international · 2024Article
- Management of osteoporosis in patients with chronic kidney disease.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Review
- Contemporary kidney transplantation has a limited impact on bone microarchitecture.Bone reports · 2022Article
- Natural History of Bone Disease following Kidney Transplantation.Journal of the American Society of Nephrology : JASN · 2022Observational
- Editorial: Management of osteoporosis in patients with chronic kidney disease.Frontiers in medicine · 2022Article
Corrections and comments
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- Commented on byAuthors' Reply.2019
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBone and mineral disorders commonly affect kidney transplant (KTx) recipients and have been associated with a high risk of fracture. Bisphosphonates may prevent or treat bone loss in such patients, but there is concern that these drugs might induce adynamic bone disease (ABD).
methodsIn an open label, randomized trial to assess the safety and efficacy of zoledronate for preventing bone loss in the first year after kidney transplant, we randomized 34 patients before transplant to receive zoledronate or no treatment. We used dual-energy x-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and bone biopsies to evaluate changes in bone in the 32 evaluable participants between the time of KTx and 12 months post-transplant.
resultsBoth groups of patients experienced decreased bone turnover after KTx, but zoledronate itself did not affect this outcome. Unlike previous studies, DXA showed no post-transplant bone loss in either group; we instead observed an increase of bone mineral density in both lumbar spine and total hip sites, with a significant positive effect of zoledronate. However, bone biopsies showed post-transplant impairment of trabecular connectivity (and no benefit from zoledronate); HR-pQCT detected trabecular bone loss at the peripheral skeleton, which zoledronate partially attenuated.
conclusionsCurrent immunosuppressive regimens do not contribute to post-transplant central skeleton trabecular bone loss, and zoledronate does not induce ABD. Because fractures in transplant recipients are most commonly peripheral fractures, clinicians should consider bisphosphonate use in patients at high fracture risk who have evidence of significantly low bone mass at these sites at the time of KTx.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.