Loss of Bone Mineral Density in Renal Transplantation Recipients

Ünal, Aydın; Koçyiğit, İsmail; Sipahioğlu, Murat Hayri; Tokgöz, Bülent; Kavuncuoğlu, Feridun; Oymak, Oktay; Utaş, Cengiz

doi:10.1016/j.transproceed.2010.07.106

Cited by 20 publications

(20 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Secondary hyperparathyroidism due to vitamin D insufficiency has been associated with bone loss in the general osteoporotic population in some races but not others . A positive correlation between vitamin D levels and BMD was found in a Turkish but not in a Caucasian population of renal transplant patients . No correlation was found between 25(OH)D levels and TBS values in a cross‐sectional study conducted on 40 kidney transplant patients .…”

Section: Discussionmentioning

confidence: 92%

“…Our findings suggest that especially in renal transplant patients, the complicated pathophysiology of renal osteodystrophy with altered bone turnover and hyperparathyroidism may overshadow the consequences of vitamin D insufficiency per se on bone density and quality. The impact of ethnic differences on the effects of vitamin D deficiency on bone mass and bone quality also cannot be excluded as has been found in the studies alluded to earlier …”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Chandran

Ying

Kwee

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

The evolution of trabecular bone score (TBS) and bone mineral density (BMD) over the first 5 years after renal transplantation was prospectively evaluated in 164 patients. Dual energy X-ray absorptiometry (DXA) scans were performed at 0, 6, 12, 24, and 60 months. Cumulative steroid dose, serum 25(OH)D, calcium, parathyroid hormone, and total ALP levels at these time points were checked. Incident fractures were identified from X-rays/vertebral fracture assessments. Mean (SD) age, TBS, and lumbar spine BMD at baseline were 47.11 (9.53), 1.424 (0.097), and 0.935 (0.183) gm/cm 2 , respectively. Baseline TBS was lower in tertiary 1.38 (0.07) vs secondary hyperparathyroidism 1.43 (0.01) vs post-parathyroidectomy 1.46 (0.11); P = .035. Trabecular bone score and BMD significantly decreased from baseline->6 months, changes after that at consecutive time points were non-significant. 11% had incident fractures during the follow-up period, majority being metatarsal with no vertebral or hip fractures noted. This first prospective evaluation of TBS and BMD evolution at multiple time points over 5 years suggest that microarchitectural and bone density deteriorations post-renal transplantation stabilize after 6 months. Stabilization of these parameters could partially account for the absence of major fractures noted in this Asian population. Possible genetic and ethnic differences in fracture risk between Asian and Caucasian renal transplant patients have to be explored through large population-based studies. K E Y W O R D SAsian, bone mineral density, fracture, kidney transplantation, renal transplantation, trabecular bone score 2 of 9 | CHANDRAN et Al fracture rates have been claimed to be up to 34% higher in the first 2 years after transplantation compared to the previous year on dialysis. 2 Other studies have found fracture event rates ranging from 5.9 to 7.0 per 1000 years. 3 The most common sites of fracture following renal transplantation have been reported to be in the vertebrae with prevalence rates of up to 38.5% on average follow-up of 4.6 years in one study 4 and in the feet 5 though hip fracture incidence rates of up to 3.8/1000 6 have also been reported.. The fracture incidence and prevalence rates reported following renal transplantation have exclusively been from studies conducted in western populations. In an earlier study of ours on South East Asians living in Singapore, no fractures were observed in the first year following renal transplantation. 7Whether or not these fractures that have been reported to occur, happen as a result of bone mineral density losses or due to compromised bone quality and microarchitectural changes is not clear. Bone mineral density as measured by dual energy X-ray absorptiometry (DXA) only estimates the amount of mineral but not other important key elements that contribute to bone strength such as bone microarchitecture. The only way so far to delineate bone microarchitecture is either through modalities such as micro QCT and HrPQCT with their attendant high radiation exposure, or t...

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Chandran

Ying

Kwee

et al. 2019

Clinical Transplantation

View full text Add to dashboard Cite

show abstract

“…After transplantation, immobility, steroids and other immunosuppressants, and the effects of residual hyperparathyroidism may exacerbate existing abnormalities [29]. Nutritional status is relevant in that calcium deficiency [33], a low body weight [34], low body mass index (BMI) and low 25 hydroxy vitamin D levels have been found to correlate with low BMD posttransplant [35]. Nutritional status is relevant in that calcium deficiency [33], a low body weight [34], low body mass index (BMI) and low 25 hydroxy vitamin D levels have been found to correlate with low BMD posttransplant [35].…”

Section: Bone Diseasementioning

confidence: 99%

Nutritional Management of Kidney Transplant Recipients

Chan

Chadban

2013

Nutritional Management of Renal Disease

View full text Add to dashboard Cite

“…Hastaların yaş ortalaması 46 ± 10,5 yıl ( 19-62) idi. Nakil öncesi VKİ'leri ortalama 23,5 ± 3,8 kg/m² (15,8) idi. Hastaların 16'sına (%17,4) önleyici nakil yapıldı, 76 hasta (%82,6) hemodiyaliz ve/veya periton diyalizi sonrası nakil oldu.…”

Section: Bulgularunclassified

“…Verici kaynağına baktığımızda, Ünal ve ark.nın yaptığı çalışmada verici kaynağı (canlı/kadaverik) ile kemik mineral yoğunluğu evreleri arasında istatiksel olarak anlamlı bir ilişki bulunmamıştı (8). Bizim çalışmamızda da, kemik mineral yoğunluğu ile hastaların canlı ya da kadavradan böbrek nakli olmaları arasında anlamlı bir farklılık görülmedi.…”

Section: Gereç Ve Yöntemlerunclassified

Risk Factors for Osteoporosis in Renal Transplant Recipients

Karataş¹,

Erdem²,

Kaya³

et al. 2012

Turk Neph Dial Transpl

View full text Add to dashboard Cite

Öz amaÇ: Çalışmamızın amacı, böbrek nakli yaptığımız işlevsel grefti olan hastalarda osteoporoz sıklığını ve risk etmenlerini belirlemektir. gErEÇ ve YÖntEMlEr: 1997-2010 yılları arasında böbrek nakli yapılan, nakil sonrası kemik mineral yoğunluğu (KMY) ölçümü olan 92 hasta ile çalışmamız yapıldı.BulgulAr: 92 hastamızın 57'si (%62) erkek, 35'i (%38) kadın idi. Hastaların yaş ortalaması 36 yıldı (19-62 yıl). Femur ve/veya lomber vertebra KMY sonuçlarına göre; 39 (%42,4) hasta normal, 39 (%42,4) hastada osteopeni ve 14 (%15,2) hastada osteoporoz vardı. KMY sonuçları ile yaşın, cinsiyetin, vücut kitle indeksinin, paratiroidektomi durumunun, toplam steroid ve bağışıklığı baskılayıcı ilaç dozunun, KMY ölçümü sırasındaki serum kreatinin, kalsiyum, fosfor, alkalen fosfataz düzeylerinin arasında anlamlı ilişki yoktu (p>0,05).SOnuÇ: Bizim çalışmamızda, risk faktörlerin hiçbirisi ile KMY arasında anlamlı bir ilişki saptanmadı. Bu bulgular; tek başına KMY ölçümünün böbrek naklinden sonra gelişmesi olası kemik hastalığını izlemede iyi bir gösterge olmadığını göstermektedir. Bu konuda pratik yeni yöntemlere gereksinim vardır.AnAhtAr SÖzCüKlEr: Kronik böbrek hastalığı, Böbrek nakli, Kemik mineral yoğunluğu abstract OBJECtIVE: The aim of our study was to determine the frequency and risk factors of osteoporosis in patients who had undergone renal transplantation in our clinic and had a functional graft. MAtErIAl and MEthODS:This study included 92 patients who had undergone renal transplantation between 1997 and 2010 and whose bone mineral density was measured after transplantation. rESultS: Our study included 92 patients. 57 patients (62%) were male and 35 (38%) were female. The mean age of the patients was 36 years (range: 19-62 years). According to the bone mineral density in the femur and/or lumbar vertebrae, 39 (42.4%) patients were normal, 39 (42.4%) had osteopenia and 14 (15.2%) had osteoporosis. There was no statistical relationship between the patients' age, gender, body mass index, history of parathyroidectomy, total steroid and immunosuppressive drug dose, creatininecalcium-phosphorus-alkaline phosphatase level at the time of the bone mineral density measurement and bone mineral density (p>0,05). COnCluSIOn:We did not find any relationship between the above risk factors and bone mineral density. These findings show that bone mineral density is not a good parameter in the follow-up of bone disease after renal transplantation.

show abstract

Loss of Bone Mineral Density in Renal Transplantation Recipients

Cited by 20 publications

References 13 publications

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Nutritional Management of Kidney Transplant Recipients

Risk Factors for Osteoporosis in Renal Transplant Recipients

Contact Info

Product

Resources

About