Management of bone and mineral disease in renal transplant patients

Mineral and bone disease in the posttransplantation patient is common and requires thorough evaluation for appropriate management. This includes secondary renal osteodystrophy, rickets, osteomalacia, osteoporosis, and osteonecrosis. Biochemical markers along with imaging and bone biopsy help to establish the diagnosis and treatment planning. Lack of appropriate management plan can lead to chronic pains, fractures, and osteonecrosis affecting long-term bone health. Tailoring immunosuppressants with appropriate medical therapy, nutritional supplements, and anti-resorptive agents is the mainstay of treatment. Here, we discuss the current management strategies with illustrative cases.