Aseptic Necrosis After Renal Transplantation in Children

The Prevalence of Osteopenia in Pediatric Renal Allograft Recipients Varies with the Method of Analysis

“…The overall risk of disabling bone disease following childhood renal transplantation has been reported repeatedly (14,15,17–20), and longitudinal studies demonstrate loss of lumbar BMD among pediatric renal allograft recipients (16,31). Despite the issues raised regarding the validity of DEXA as a measure of osteopenia it remains the best available practical and noninvasive technique.…”

Promoting bone health in children and adolescents following solid organ transplantation

“…GCs are also linked to increased incidence of avascular necrosis with rates as high as 6%-25%; moreover, rates have been linked to cumulative GC dose including number of rejection episodes 73,74. In addition to effects on bone strength there is also the relationship between GC exposure and inhibition of linear growth,75 and retrospective clinical studies have demonstrated improved growth velocity in patients with reduced GC dosing 76,77.…”

Glucocorticoids in Renal Disease

“…the latter being related to increased marrow release [27], Other findings, previously mentioned, in clude monocytopenia, lymphopenia and eosinopenia. These findings arc possibly related to the alteration in lymphocyte recirculation pattern [27,29], A unique bone disease, termed glucocorticoid-induced osteopenia, is especially prevalent in children [34], This disorder commonly results in spine compression frac tures and avascular necrosis of the femoral head [35], Aseptic necrosis is particularly frequent after renal trans plantation [36] and in patients with systemic lupus ery thematosus [37]. Histologically, osteoporosis is found, and a variety of mechanisms are at play, including inhi bition of bone formation, alterations in collagen metabo lism.…”