Elsevier

Transplantation Proceedings

Volume 41, Issue 7, September 2009, Pages 2820-2822
Transplantation Proceedings

Kidney transplantation
Complication: Metabolic
Osteoporosis and Related Risk Factors in Renal Transplant Recipients

https://doi.org/10.1016/j.transproceed.2009.07.018Get rights and content

Abstract

Decreased bone mineral density is a common problem after kidney transplantation. Osteoporosis has a major role in morbidity in these patients. We evaluated the incidence of osteoporosis and determined risk factors in 77 patients aged 17 to 50 years who had undergone renal transplantation 6 months to 2 years previously. Bone mineral densitometry was performed using dual-energy x-ray absorptiometry. The incidence of osteoporosis was 26% (20 of 77 patients). Mean (SD) age of affected patients was 34.6 (8.7) years. The most common sites of osteoporosis were the hip (osteoporotic in 19 patients [24.7%] and osteopenic in 42 [54.5%]) and the spine (osteoporotic in 6 patients [7.8%] and osteopenic in 52 [67.5%]). There was a significant relationship between posttransplantation creatinine concentration and hip osteoporosis (P = .01). No relationship was observed between osteoporosis and age, sex, body mass index, duration of hemodialysis therapy, cumulative dosage of any drugs, or use of pulsed methylprednisolone therapy. A hip or spine z score of 1 or less had no relationship to the number of steroid pulse sessions but was significantly related to the total dosage of cyclosporine (P < .001), prednisolone (P < .001), and mycophenolate mofetil (P < .05). A hip z score of less than 1 was related to the posttransplantation period (P = .02). In conclusion, osteoporosis is a frequent complication that requires detection and treatment to reduce morbidity.

Section snippets

Materials and Methods

The study included 85 patients aged 17 to 50 years who had undergone renal transplantation 6 months to 2 years previously. Patients with a history of thyroid disease before or after transplantation were excluded. Baseline data included age, sex, height, and weight; duration of dialysis therapy before transplantation; days posttransplantation; immunosuppression regimen; cumulative dosages of prednisolone, cyclosporine, and mycophenolate mofetil (MMF) (CellCept; Roche Laboratories Inc, Lisle,

Results

Seventy-seven renal transplant recipients underwent BMD. Twenty-eight (36.4%) were women and 49 (63.6%) were men. Overall mean (SD; range) age was 34.68 (8.71; 17–51) years. Osteoporosis in the hip or spine regions was observed in 20 patients (26%). Hip BMD revealed normal findings in 16 patients (20.8%), osteopenia in 42 (54.5%), and osteoporosis in 19 (24.7%). Spine BMD revealed normal findings in 19 patients (24.7%), osteopenia in 52 (67.5%), and osteoporosis in 19 (24.7%). T test scores

Discussion

Osteoporosis was common in our patients. More than 90% of patients with osteoporosis had hip osteoporosis, which demonstrates the importance of diagnosis and initiation of treatment to reduce associated morbidity. Our patients were younger than 50 years, which may explain the prevalence of osteoporosis in a relatively young population and underscores the risk of fracture in subsequent years.

Cumulative dosage of cyclosporine was not predictive of bone loss in our study, although it has been

References (15)

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