Pamidronate used to attenuate post-renal transplant bone loss is not associated with renal dysfunction.

BACKGROUND: Pamidronate is a second-generation bisphosphonate that has been used to attenuate post-renal transplant bone loss, but its effect on the function of the renal allograft is unclear. Therefore, we evaluated the long-term renal function in 57 subjects who had participated in a prospective, randomized clinical trial using pamidronate to attenuate bone loss in the renal transplant recipient. METHODS: Thirty subjects (PAM) received intravenous pamidronate, 60 mg at baseline post-transplant and 30 mg in months 1, 2, 3 and 6 post-transplant, while 27 subjects (CON) did not receive pamidronate. We followed renal function, need for renal replacement therapy following transplant rejection, and mortality for 3 years following the start of the original study. RESULTS: PAM did not have increased incidence of renal dysfunction or mortality compared with CON at any time point during the 3 years of follow-up. The incidence of proteinuria was also not different between the two groups. CONCLUSIONS: The prophylactic use of pamidronate in the above doses to attenuate bone loss in renal transplant recipients is not associated with higher incidence of renal dysfunction or mortality in a 3 year follow-up study. These findings may support the use of bisphosphonates in the treatment of early renal transplant-related bone loss.