There is about 18 percent prevalence with a range of 5 to 21 percent of a fracture occurring in the first couple of years post transplant. This is mainly due to a change in bone mass caused mainly by immuno-suppressive medications--prednisone, cyclosporin, FK506, azathioprine, immobilization. PTH levels remain elevated in many renal TX. Patients Gonadotrophin deficiency is a major problem in renal disease. There are no drugs available for the treatment of this problem. There are investigational therapies--estrogens, calcitonin, bisphosphonates, alfacalcidol, anabolic factor. Parathyroid hormone is in clinical trial.