Table 3.

Change in Bone Mineral Density in Postrenal Transplant Patients Between Bisphosphonate and Control Groups.

Study	BMD
	Lumbar	Femoral neck	Other
Sánchez-Escuredo et al26 I1: n = 35 I2: n = 34	T-score at pretreatment/12 months I1: −1.7 ± 0.8/−1.4 ± 0.6 I2 −1.9 ± 0.8/−1.5 ± 0.8	T-score at pretreatment/12 months I1: −2.1 ± 0.7/−1.8 ± 0.9 I2: −2.2 ± 0.6/−1.8 ± 0.8
Okamoto et al27 I: n = 5 C: n = 7	NA	NA	Total BMD: % change from baseline I: 1.86% ± 0.85%, P < .05 No other raw data provided
Walsh et al28 I: n = 46 C: n = 47	% change in BMD at 12 months from baseline AMTD: 7.78%, 95% CI: 5.15-10.41, P < .001 Significant difference between groups at 24 months No raw data	% change in BMD at 12 months from baseline AMTD: 2.51%, 95% CI: −0.33 to 5.35, P = .08 No significant difference between groups at 24 months No raw data	Ward’s area: Significant increase in I vs C at both 12 and 24 months AMTD: 5.83%, 95% CI: 2.19-9.45, P < .01 Total hip: Significant increase in I vs C at both 12 and 24 months AMTD: 2.79%, 95% CI: 0.92-4.67, P < .01
Lan et al29 I: n = 23 C: n = 23	Mean g/cm2 at pretreatment/6 months I: (L1) 0.781 ± 0.117/0.820 ± 0.114, NS C: (L1) 0.760 ± 0.062/0.771 ± 0.069, NS	Mean g/cm2 at pretreatment/6 months I: 0.650 ± 0.107/0.731 ± 0.109, P < .05 C: 0.657 ± 0.061/0.676 ± 0.060, NS Significant difference between groups at 6 months posttreatment,P < .05	Trochanter: Mean g/cm2 at pretreatment/6 months I: 0.524 ± 0.093/ 0.572 ± 0.103, NS C: 0.54 ± 0.082/ 0.561 ± 0.079, NS
Schwarz et al30 I: n = 9 C: n = 10	Z-score at 6 months to 32 months posttreatment I: No difference C: No difference NS between groups No raw data	Z-score at 6 months to 32 months posttreatment I: −1.6 (2.9) to −1.2 (1.9), P < .05 between groups, P < .05 C: −1.3 (2.6) to −0.2 (3.6), P < .05 between groups, P < .05 median and range
Fan et al31 I: n = 9 C: n = 8	Mean g/cm2 at baseline/1 year/4 years I: 1.15 ± 0.07/(1 year) 1.11 ± 0.05, NS/(4 years) 1.10 ± 0.04, NS C: 1.27 ± 0.07/(1 year) 1.2 ± 0.5, P < .05/(4 years) 1.21 ± 0.08, NS	Mean g/cm2 at baseline/1 year/4 years I: 0.93 ± 0.05/(1 year) 0.94 ± 0.04, NS/(4 years) 0.88 ± 0.04, NS C: 1.08 ± 0.07/ (1 year) 0.98 ± 0.06, P < .05/(4 years) 0.94 ± 0.06, P < .01
Jeffery et al32 I: n = 57 C: n = 60	Mean g/cm2 at pretreatment/12 months I: 0.984 ± 0.149/1.025 ± 0.143, P < .001 C: 1.014 ± 0.15/1.034 ± 0.146, P < .01 NS between groups at 12 months (P = .082)	Mean g/cm2 at pretreatment/12 months I: 0.809 ± 0.092/0.836 ± 0.107, P < .001 C: 0.830 ± 0.144/0.857 ± 0.125, P < .05 NS between groups at 12 months (P = .96)
Koc et al33 I1: n = 8 I2: n = 8 C: n = 8	Mean g/cm2 at 12 months/pretreatment I1: 1.050 ± 0.086/1.122 ± 0.094, P < .01 I2: 0.963 ± 0.142/ 1.034 ± 0.119, P < .05 C: 1.082 ± 0.187/1.095 ± 0.142, NS % change of BMD I1: 8.15% ± 9.2% I2: 6.89% ± 4.03% C: 0.06% ± 1.41% P < .05 compared with control	Mean g/cm2 at 12 months/pretreatment I1: 0.826 ± 0.121/ 0.902 ± 0.092, P < .05 I2: 0.816 ± 0.121/0.902 ± 0.092, NS C: 0.933 ± 0.082/0.947 ± 0.082, NS % change of BMD I1: 9.34 ± 10.47% I2: 8.51 ± 13.8% C: 1.92 ± 2.52% NS compared with control
Tillmann et al34 I: n = 30 C: n = 30	Z-score at pre-treatment/26.8 ± 12.1 months I: −2.25 ± 1.11/−1.78 ± 1.30, P < .05 C: −0.52 ± 1.52/−0.28 ± 1.55, P < .05 Change in BMD I: 0.055 ± 0.066 C: 0.033 ± 0.079 NS between groups, P = .217	Z-score at pretreatment/26.8 ± 12.1 months I: −1.97 ± 0.85/−1.73 ± 0.71, P < .05 C: −0.69 ± 1.31/−0.55 ± 1.12, P < .05 Change in BMD I: 0.025 ± 0.077 C: 0.013 ± 0.106 NS between groups, P = .647
Naylor et al35 n = 329	Z-score −0.4 ± 1.6 At median 6 months (baseline) −0.2 ± 1.6, P < .001 vs baseline At mean 2.7 years +0.5 ± 1.5, P < .001 vs baseline At mean 8.2 years	Z-score −0.7 ± 1.1 At median 6 months (baseline) −0.6 ± 1, P < .01 vs baseline At mean 2.7 years +0.1 ± 1.5, P < .001 vs baseline At mean 8.2 years	Hip Z-score −0.7 ± 1.1 At median 6 months (baseline) −0.6 ± 1.1, P < .01 vs baseline At mean 2.7 years −0.5 ± 1.1, P < .001 vs baseline At mean 8.2 years
Yamamoto et al36 n = 24	Mean g/cm2 pretreatment/12 months/24 months (Baseline) 0.80 ± 0.11/(12-month) 0.78 ± 0.12, NS/(24-month) 0.79 ± 0.15, NS
Huang et al37 I: n = 34 C: n = 42	For 76 included patients T-score at pretreatment/14 ± 1.6 months −1.53 ± 1.24/−1.32 ± 1.26, P < .001 BMD: Mean g/cm2 at pretreatment/14 ± 1.6 months 0.90 ± 0.14/0.92 ± 0.14, P = .001	T-score at pretreatment/14 ± 1.6 months −2.45 ± 0.96/−2.42 ± 1.02, NS BMD: Mean g/cm2 at pretreatment/14 ± 1.6 months 0.68 ± 0.12/ 0.69 ± 0.13, NS	Hip: T-score at pretreatment/14 ± 1.6 months −1.76 ± 0.97/−1.68 ± 1.07, NS BMD: Mean g/cm2 at pretreatment/14 ± 1.6 months 0.81 ± 0.14/0.81 ± 0.14, NS
Conley et al38 I: n = 315 C: n = 239	T-score at mean 1.2 ± 0.05 years posttransplant/2.5 ± 0.05 years posttransplant I: −1.4 ± 1.3/−1.0 ± 1.3 C: 1.3 ± 0.5/0 ± 1.4 P < .001 between groups	T-score at mean 1.2 ± 0.05 years posttransplant/2.5 ± 0.05 years posttransplant I: −1.9 ± 1/−1.7 ± 1 C: 1.0 ± 0/−1.0 ± 1.0 P < .001 between groups
Ahn et al39 n = 294	Mean different in T-score at 12, 24, and 36 months compared with baseline 1 year C/I: −0.51 ± 0.66/−0.13 ± 0.73, P < .05 (n = 275/19) 2 year C/I: −0.76 ± 0.74/−0.4 ± 0.79, P < .05 (n = 151/45) 3 year C/I: −0.83 ± 0.83/−0.5 ± 0.8, P = .10 (n = 74/32)	Mean different in T-score at 12, 24 and 36 months compared with baseline 1 year C/I: −0.22 ± 0.69/0.13 ± 0.55, P < .05 (n = 273/19) 2 year C/I: −0.38 ± 0.82/−0.1 ± 0.77, P = .20 (n = 150/44) 3 year C/I: −0.43 ± 0.85/0.20 ± 0.94, P = .21 (n = 75/31)
Cruz et al40 I: n = 29 C: n = 28	T-score at pretreatment/12 months I: −1.71 ± 0.19/no raw data result (change in T-score: + 3.4% ± 0.6%, P < .001) C: −0.70 ± 0.24/no raw data result	T-score at pretreatment/12 months I: −1.43 ± 0.13/−1.34 ± 0.14(P < .01) (change in T-score +1.6 ± 0.6%, P < .001) C: −1.10 ± 0.15/no raw data result	Total femur: T-score at pretreatment/12 months I: −1.43 ± 0.13/−1.34 ± 0.14 (P < .01) (change in T-score: +1.6 ± 0.6%, P < .001) C: −0.67 ± 0.16/no raw data result
Arlen et al41 I: n = 25 C: n = 24	Mean g/cm2 at pretreatment/23.3 ± 6.6 months I: 0.981 ± 0.138/1.021 ± 0.140 C: 1.134 ± 0.168/1.143 ± 0.175 Change in % BMD (I vs C) 4.3% ± 6.1% vs 0.55 ± 5.3%, P < .05	Mean g/cm2 at pretreatment/23.3 ± 6.6 months (change in % BMD) I: 0.784 ± 0.102/ 0.810 ± 0.110 C: 0.867 ± 0.137/ 0.893 ± 0.147 Change in % BMD (I vs C) 3.4 ± 6.5% vs 3.2 ± 6.4% NS	Trochanter: Mean g/cm2 at pretreatment/23.3 ± 6.6 months (change in % BMD) I: 0.619 ± 0.094/0.683 ± 0.126 C: 0.725 ± 0.116/ 0.738 ± 0.109 Change in % BMD (I vs C) 10.3 ± 11.9% vs 2.2 ± 5.7%, P < .05

Note. BMD = bone mineral density; I = intervention; C = control; n = number; AMTD = adjusted mean treatment difference; CI = confidence interval. White is RCT, Grey shaded region is Observational trials.