Evenepoel P, Claes K, Meijers B, et al. - Natural history of mineral metabolism, bone turnover and bone mineral density were presented in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol. Researchers included 69 adult transplant recipients (39 males; ages 51.1 ± 12.2 years), free of antiresorptive therapy and managed with a steroid minimization immunosuppressive protocol, into a 5-year prospective observational study to analyze alterations in areal bone mineral density, mineral metabolism and bone remodelling. This study evaluated dual energy x-ray absorptiometry, laboratory parameters of mineral metabolism (including parathyroid hormone, sclerostin and fibroblast growth factor 23) and non-renal cleared bone turnover markers (bone-specific alkaline phosphatase, trimeric N-terminal propeptide and tartrate-resistant acid phosphatase 5b) at baseline and 1 and 5 years post-transplantation. The evidence showed that BMD alterations are limited, highly variable and related to remodelling activity rather than corticosteroid exposure in de novo renal transplant recipients treated with a steroid minimization immunosuppressive protocol.