Incidence and long-term cost of steroid-related side effects after renal transplantation

Veenstra, David L.; Best, Jennie H.; Hornberger, John; Sullivan, Sean D.; Hricik, Donald E.

doi:10.1016/s0272-6386(99)70414-2

Cited by 279 publications

(141 citation statements)

References 46 publications

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“…Other factors significantly associated with rejection were cadaver kidney, delayed graft function, AfricanAmerican donor kidney, HLA mismatch, recipient sensitization, older donor age, earlier year of transplant, and male gender, as previously reported (12).…”

Section: Resultssupporting

confidence: 71%

“…However, the remarkable predominance of AVN as an indication for THA in the renal transplant population would imply a continued relatively high incidence of AVN in this population, despite recent efforts to reduce cumulative corticosteroid dosing. The significance of allograft rejection as a risk factor for THA at least indirectly suggests a role for corticosteroids in the development of avascular necrosis, as noted by other investigators (12). Previous investigation by this institution found that among patients hospitalized after renal American Journal of Transplantation 2002; 2: 999-1004 transplantation with a primary diagnosis of avascular necrosis, 58% underwent THA (17).…”

Section: Discussionmentioning

confidence: 54%

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Hospitalizations for Total Hip Arthroplasty after Renal Transplantation in the United States

Bucci

Oglesby

Agodoa

et al. 2002

American Journal of Transplantation

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The national incidence of and factors associated with total hip arthroplasty in renal transplant recipients has not been reported. We conducted an historical cohort study of 42 096 renal transplant recipients in the United States between 1 July 1994 and 30 June 1998. Primary outcomes were associations with hospitalizations for a primary discharge code of total hip arthroplasty (ICD9 procedure code 81.51x) within 3 years after renal transplant using Cox regression. Renal transplant recipients had a cumulative incidence of total hip arthroplasty of 5.1 episodes/1000 personyears, which is 5-8 times higher than reported in the general population. Avascular necrosis of the hip was the most frequent primary diagnosis associated with total hip arthroplasty in this population (72% of cases). Repeat surgeries were performed in 27% of patients with avascular necrosis, vs. 15% with other diagnoses. Total hip arthroplasty was more frequent in transplant recipients who were older, African American, or who experienced allograft rejection. Mortality after total hip arthroplasty was 0.21% at 30 days and 15% at 3 years, similar to the mortality of all transplant recipients. The most common indication for total hip arthroplasty after renal transplant is avascular necrosis of the hip, in contrast to the general population. Although repeat surgeries are common, total hip arthroplasty is well tolerated and is not associated with increased mortality in this population.

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Section: Resultssupporting

confidence: 71%

Section: Discussionmentioning

confidence: 54%

Hospitalizations for Total Hip Arthroplasty after Renal Transplantation in the United States

Bucci

Oglesby

Agodoa

et al. 2002

American Journal of Transplantation

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“…Veenstra et al [26] report findings which suggest that in renal transplant patients who typically receive high doses of steroids over prolonged periods of time the incidence of hypertension is 15%, diabetes mellitus 10%, peripheral fractures 2%, avascular necrosis of the hip 8% and cataracts 22%. The mean annual health care costs of these side effects was estimated to be $530 in 1996 prices (approximately £350 in 1998 prices).…”

Section: Impact Of Side Effectsmentioning

confidence: 99%

Cost–utility analysis of intravenous immunoglobulin and prednisolone for chronic inflammatory demyelinating polyradiculoneuropathy

McCrone

Chisholm

Knapp

et al. 2003

Euro J of Neurology

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There is a paucity of economic evidence relating to interventions for peripheral nerve disorders and the aim of this study was to illustrate the application of economic evaluation in this area by making a comparison of the cost-effectiveness of intravenous immunoglobulin and prednisolone treatment for chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Patients (n=32) were recruited to a double-blind randomised cross-over trial from nine European centres and received either prednisolone or intravenous immunoglobulin during the first six-week treatment period, followed by a four-week washout period after which the other treatment was received.Service use, quality of life and physical disability were measured at baseline and at the end of both treatment periods. Cost and outcome data were available for 25 patients who completed the first arm of the study but for only 16 who completed both arms.Therefore, the focus of the economic evaluation was on the initial treatment period.Baseline costs were controlled for using a bootstrapped multiple regression model. The cost difference between the two treatments was estimated to be £1608 for the initial six

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“…Femoral head osteonecrosis (ON) is a well-known complication after high-dose corticosteroid treatment in adults and children, with an incidence of 8% to 25% [15,26,32]. Disturbed blood supply is believed by some to be an early consequence [9,12].…”

Section: Introductionmentioning

confidence: 99%

Differential Expression of Vascular Endothelial Growth Factor in Glucocorticoid-related Osteonecrosis of the Femoral Head

Varoga

Drescher

Pufe

et al. 2009

Clin Orthop Relat Res

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Incidence and long-term cost of steroid-related side effects after renal transplantation

Cited by 279 publications

References 46 publications

Hospitalizations for Total Hip Arthroplasty after Renal Transplantation in the United States

Hospitalizations for Total Hip Arthroplasty after Renal Transplantation in the United States

Cost–utility analysis of intravenous immunoglobulin and prednisolone for chronic inflammatory demyelinating polyradiculoneuropathy

Differential Expression of Vascular Endothelial Growth Factor in Glucocorticoid-related Osteonecrosis of the Femoral Head

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