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Bisphosphonates for preventing bone disease in kidney transplant recipients : a meta-analysis of randomized controlled trials

(2016) TRANSPLANT INTERNATIONAL. 29(2). p.153-164
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Abstract
An estimated 60% of kidney transplant recipients have mineral bone disease and about 0.5% break their hip within the first year after transplantation. We conducted a systematic review of benefits and harms of bisphosphonates in kidney transplant recipients. We searched CENTRAL (Issue 5, 2015) for randomized controlled trials in all languages and screened the reference list of an earlier Cochrane review. One reviewer identified the trials, extracted all data, and assessed risk of bias. Meta-analysis used a random effects model, with results expressed as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Bisphosphonates have uncertain effects on death (RR 0.45, CI 0.04-4.69) and vertebral fractures (RR 0.58, CI 0.24-1.43, I(2) 0%). Bisphosphonates moderately to importantly reduce the loss of vertebral bone mineral density (MD 5.98%, CI 3.77-8.18% change from baseline in g calcium/cm² at 12 months, I(2) 91%) and femoral bone mineral density (MD 5.57%, 3.12-8.01% change from baseline in g calcium/cm² at 12 months, I(2) 69%). At this stage, insufficient evidence exists to support routine use of bisphosphonates to reduce fracture risk after kidney transplantation. Data on important health outcomes are lacking, surrogate outcomes poorly reflect bone quality in kidney transplant recipients, and serious adverse events are not studied and reported systematically.
Keywords
bisphosphonates, systematic review, kidney transplantation, ALENDRONATE, RENAL-TRANSPLANTATION, MANAGEMENT, PAMIDRONATE, MINERAL DENSITY, OSTEOPOROSIS

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MLA
VERSELE, EMMANUELLE, et al. “Bisphosphonates for Preventing Bone Disease in Kidney Transplant Recipients : A Meta-Analysis of Randomized Controlled Trials.” TRANSPLANT INTERNATIONAL, vol. 29, no. 2, 2016, pp. 153–64, doi:10.1111/tri.12691.
APA
VERSELE, E., Van Laecke, S., Dhondt, A., Verbeke, F., Vanholder, R., Van Biesen, W., & Nagler, E. (2016). Bisphosphonates for preventing bone disease in kidney transplant recipients : a meta-analysis of randomized controlled trials. TRANSPLANT INTERNATIONAL, 29(2), 153–164. https://doi.org/10.1111/tri.12691
Chicago author-date
VERSELE, EMMANUELLE, Steven Van Laecke, Annemieke Dhondt, Francis Verbeke, Raymond Vanholder, Wim Van Biesen, and Evi Nagler. 2016. “Bisphosphonates for Preventing Bone Disease in Kidney Transplant Recipients : A Meta-Analysis of Randomized Controlled Trials.” TRANSPLANT INTERNATIONAL 29 (2): 153–64. https://doi.org/10.1111/tri.12691.
Chicago author-date (all authors)
VERSELE, EMMANUELLE, Steven Van Laecke, Annemieke Dhondt, Francis Verbeke, Raymond Vanholder, Wim Van Biesen, and Evi Nagler. 2016. “Bisphosphonates for Preventing Bone Disease in Kidney Transplant Recipients : A Meta-Analysis of Randomized Controlled Trials.” TRANSPLANT INTERNATIONAL 29 (2): 153–164. doi:10.1111/tri.12691.
Vancouver
1.
VERSELE E, Van Laecke S, Dhondt A, Verbeke F, Vanholder R, Van Biesen W, et al. Bisphosphonates for preventing bone disease in kidney transplant recipients : a meta-analysis of randomized controlled trials. TRANSPLANT INTERNATIONAL. 2016;29(2):153–64.
IEEE
[1]
E. VERSELE et al., “Bisphosphonates for preventing bone disease in kidney transplant recipients : a meta-analysis of randomized controlled trials,” TRANSPLANT INTERNATIONAL, vol. 29, no. 2, pp. 153–164, 2016.
@article{7089885,
  abstract     = {{An estimated 60% of kidney transplant recipients have mineral bone disease and about 0.5% break their hip within the first year after transplantation. We conducted a systematic review of benefits and harms of bisphosphonates in kidney transplant recipients. We searched CENTRAL (Issue 5, 2015) for randomized controlled trials in all languages and screened the reference list of an earlier Cochrane review. One reviewer identified the trials, extracted all data, and assessed risk of bias. Meta-analysis used a random effects model, with results expressed as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). Bisphosphonates have uncertain effects on death (RR 0.45, CI 0.04-4.69) and vertebral fractures (RR 0.58, CI 0.24-1.43, I(2) 0%). Bisphosphonates moderately to importantly reduce the loss of vertebral bone mineral density (MD 5.98%, CI 3.77-8.18% change from baseline in g calcium/cm² at 12 months, I(2) 91%) and femoral bone mineral density (MD 5.57%, 3.12-8.01% change from baseline in g calcium/cm² at 12 months, I(2) 69%). At this stage, insufficient evidence exists to support routine use of bisphosphonates to reduce fracture risk after kidney transplantation. Data on important health outcomes are lacking, surrogate outcomes poorly reflect bone quality in kidney transplant recipients, and serious adverse events are not studied and reported systematically.}},
  author       = {{VERSELE, EMMANUELLE and Van Laecke, Steven and Dhondt, Annemieke and Verbeke, Francis and Vanholder, Raymond and Van Biesen, Wim and Nagler, Evi}},
  issn         = {{0934-0874}},
  journal      = {{TRANSPLANT INTERNATIONAL}},
  keywords     = {{bisphosphonates,systematic review,kidney transplantation,ALENDRONATE,RENAL-TRANSPLANTATION,MANAGEMENT,PAMIDRONATE,MINERAL DENSITY,OSTEOPOROSIS}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{153--164}},
  title        = {{Bisphosphonates for preventing bone disease in kidney transplant recipients : a meta-analysis of randomized controlled trials}},
  url          = {{http://doi.org/10.1111/tri.12691}},
  volume       = {{29}},
  year         = {{2016}},
}

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