Rapid loss of vertebral mineral density after renal transplantation

Article Abstract:

It has long been appreciated that the loss of bone mineral is a common complication affecting patients who have received transplanted kidneys. Much of this bone mineral loss is due to the effects of steroid drugs, which are given to help prevent transplant rejection. However, the drug cyclosporin is now the mainstay of treatment to prevent rejection, and lower doses of steroid drugs may be used. A study was conducted to determine if the newer treatment methods have reduced the problem of bone mineral loss in kidney transplant patients. Bone mineral loss was thoroughly investigated in 20 patients who had received a kidney transplant. All patients were treated with azathioprine, cyclosporin, and low doses of the steroid prednisone. Measurements of bone density revealed that 18 months after kidney transplantation, the mineral density of the spinal column had decreased by almost 9 percent. The majority of this mineral loss occurred within the first six months after transplantation. Measurement of the density of the radius, a bone in the arm, indicated that this bone actually increased in density. Nevertheless, in 10 of the 17 patients who were measured 18 months after transplantation, the density of the vertebrae of the spine had decreased below the threshold at which fractures become a potential problem. The reduction in bone mineral observed in these patients was less than that observed when kidney transplant patients received higher doses of steroid drugs. However, despite reducing the amount of bone mineral loss, this mineral loss remains a significant medical problem for kidney transplant patients. Since all of the patients in the present study received cyclosporin, it is not possible to determine the contribution that this immunosuppressive drug might have made to the total bone mineral loss observed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bones, Kidneys, Kidney transplantation, Bone density

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Effect of high-dose ibuprofen in patients with cystic fibrosis

Article Abstract:

Children with cystic fibrosis and mild lung disease might benefit from ibuprofen. Most children with cystic fibrosis have a chronic inflammation of the lungs, which prevents the lungs from clearing bacterial infections. Ibuprofen is a non-steroidal anti-inflammatory drug. Of 57 people aged 5 to 39 with cystic fibrosis, 27 took 200 milligrams of ibuprofen twice a day for four years and 30 took a placebo. By the end of the study, lung function was worse in those who took placebo compared to those who took ibuprofen. The effect was most pronounced in children younger than 13; the drug seemed to have no effect in older adults. Those taking ibuprofen also maintained their weight, but those in the placebo group lost weight. There was no significant difference between the groups in the number of times hospitalized or number of days hospitalized. The only side effects definitely attributable to ibuprofen use were conjunctivitis in one patient and nosebleed in another.

Evaluation, Prevention, Drug therapy, Lung diseases, Ibuprofen

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Growth in children with chronic lung disease

Article Abstract:

Doctors should carefully follow all children with cystic fibrosis who must take corticosteroids. Most children with cystic fibrosis develop lung disease, which is commonly treated with corticosteroids. However, corticosteroids have serious side effects, including osteoporosis and stunted growth. A study published in 2000 followed children with cystic fibrosis, some of whom had taken corticosteroids. Six years after the drug had been discontinued, researchers discovered that the boys who took prednisone were shorter than the boys who did not. Girls were not affected. Inhaled corticosteroids may be less likely to stunt growth.

Care and treatment, Editorial, Causes of, Growth disorders

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