Ensayos clínicos

Inclusion Criteria:

• Age ≥ 18 years old.
• First time liver transplant candidates deemed too early for liver transplant.
• 24 hour urine Creatinine clearance of > 40 mg/dl and/or eGFR > 60; however bone turnover markers (beta Ctx and P1NP) will be measured only in those with creatinine clearance > 60mg/dl.

Exclusion Criteria:

• Patients with prior solid organ transplantation.
• Liver/kidney combination will be excluded.
• Patients with 24 hr urine creatinine clearance < 40mL/minute.
• Patients who have been on osteoporosis medications – Bisphosphonates [Fosamax (alendronate), Actonel (risedronate), Boniva (ibandronate), or Reclast (zoledronic acid)] teriparatide (Forteo), abaloparatide (Tymlos), denosumab (Prolia), within the past 5 years.
• Use of other systemic medications that can effect bone remodeling including sex hormone replacement therapy (estrogen or testosterone), calcitonin, androgen deprivation therapy, aromatase inhibitors, or SERMS in the past 6 months.
• Underlying disease that significantly impacts bone metabolism such as primary hyperparathyroidism, hyperthyroidism, paget’s disase of bone, fibrous dyplasia, or malignancies with skeletal metastases.