Severe osteoporosis frequently is observed after kidney transplantation and some factors such as demographic characteristics and drug therapy can affect on bone mineral density (BMD). The aim of this study is to find out the effect of angiotensin converting enzyme inhibitor (ACEI) on BMD. A retrospective cohort study of 41 adult (male 33, female 8) renal transplant recipients was preformed.
Mean age, months since transplantation and weight were 40.7±11.8 years (21-66 years), 31.65 ±27.84 months (7-108 months) and 69.46 ±12 Kg (44-92 Kg) respectively. Mean daily dose of prednisolone and cyclosporine were 6.28±1.86 mg (2.50-12.5 mg) and 200.97 ±40.25 mg (125-275 mg), respectively. Osteoporosis was observed in 14 patients (34.1%) in any of fem neck or spine region (17.1% in fem neck and 29.3% in spine). 12.2% of the patients treated by ACEI had a significant lower Tscore of femural neck as compared with patients not treated (-2.43±0.5 versus -1.08±1.32, P=0.031). There were more osteoporotic patients in femural neck in ACEI treated group (60% versus 12.5%, P=0.028). It was not significantly observed decreasing of T-score of lumbar spine in ACEI-treated patients. Sex, age >=50 years versus age <50, history of diabetes, mean dose of prednisolone and cyclosporine had no significant relationships with bone loss in femur and spine.
This study suggests that ACEI can cause decreasing of BMD in femural neck. However further studies need to establish this effect