Walsh 2009.

Methods	Study design: open‐label, parallel RCT Duration of study: May 2001 to December 2003 Duration of follow‐up: 24 months
Participants	Country: UK Setting: multicentre (7 sites) Inclusion criteria: kidney transplant recipients Number: treatment group (46); control group (47) Mean age ± SD (years): treatment group (46.1 ± 12.8); control group (46.1 ± 12.9) Sex (M/F): treatment group (35/11); control group (34/13) Exclusion criteria: PTH < 150 pg/mL
Interventions	Treatment group Pamidronate: 1 mg/kg IV perioperatively, then at 1, 4, 8, and 12 months post transplant Control group No treatment Co‐interventions Calcium: 500 mg/d Vitamin D3: 400 IU/d
Outcomes	Change in BMD at lumbar spine by 12 months Incidence of fractures Change in serum calcium, phosphate, PTH, and vitamin D Biomarkers of bone turnover Acute rejection Kidney function (creatinine) Adverse events of medications
Notes	Funding source: Novartis
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Quote: "Statistical Analysis System (SAS Institute, Cary, NC)–based randomization macro; randomization was stratified for sex and baseline PTH level"
Allocation concealment (selection bias)	Low risk	Quote: "Four‐digit randomization numbers were allocated to patients through a telephone randomization process"
Blinding of participants and personnel (performance bias) All outcomes	High risk	Unblinded comparing intravenous therapy with no treatment control
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Observers blinded to treatment allocation assessed radiographs individually then conferred with 2nd observed
Incomplete outcome data (attrition bias) All outcomes	High risk	125 randomly assigned to treatment; 32 randomised participants were excluded (19 in treatment group and 13 in control group)
Selective reporting (reporting bias)	Low risk	Patient‐centred outcomes captured and reported
Other bias	High risk	Funded by Novartis; one author employee of Novartis