Osteoporosis in lung transplantation candidates with end-stage pulmonary disease

Shane, Elizabeth; Silverberg, Shonni J.; Donovan, Daniel S.; Papadopoulos, Anastasio; Staron, Ronald B.; Addesso, Vicki; Jorgesen, Birgit; McGregor, Carlton C.; Schulman, Larry L.

doi:10.1016/s0002-9343(96)00155-6

Cited by 218 publications

(124 citation statements)

References 35 publications

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“…Previous authors have observed an association between osteoporosis and COPD, emphasizing the role that nutrition, steroids, and inactivity may play in bone loss with COPD (5,(6)(7)(8). This current study highlights the relationship by demonstrating increased bone loss in two groups that are less affected by age-related bone loss, and again raises important questions about why a lung disease would affect bone turnover.…”

supporting

confidence: 68%

COPD and Bone Loss

Regan

2008

COPD: Journal of Chronic Obstructive Pulmonary Disease

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supporting

confidence: 68%

COPD and Bone Loss

Regan

2008

COPD: Journal of Chronic Obstructive Pulmonary Disease

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“…29 Although corticosteroid dosage has not been shown to be related to fracture risk in liver transplant recipients, several studies have shown a corticosteroid dosedependent effect on bone loss in patients undergoing renal, cardiac, and lung transplant. [30][31][32] Bone loss may occur soon after corticosteroid initiation and is greatest during the first year. 33 In recent years, development of new immunosuppression agents has allowed for early steroid withdrawal after organ transplant, which may reduce the incidence of osteoporosis and osteonecrosis.…”

Section: Discussionmentioning

confidence: 99%

Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

He²,

Fu³

et al. 2012

Exp Clin Transplant

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Objectives: Immunosuppressant-related hip pain can greatly affect a patient's mobility and increase the number of total hip arthroplasties. We investigated risk factors and causes of hip pain after orthotopic liver transplant. Materials and Methods:The medical records of 175 adult orthotopic liver transplant patients, who were followed-up for more than 2 years, were retrospectively reviewed. Data collected from the records included primary disease, medications, biochemical results, Child-Turcotte-Pugh score, death, rejection, and complications related to liver transplant. Results: A total of 11 patients (6.3%) complained of hip pain, which was diagnosed as calcineurininhibitor-induced pain syndrome in 4 patients (2.3%), osteonecrosis of the femoral head in 3 patients (1.7%), and osteoporosis in 2 patients (1.1%). The incidence of calcineurin-inhibitorinduced pain syndrome was related to the dosage of tacrolimus (P > .05) but independent of methylprednisolone use. The occurrence of osteonecrosis of the femoral head was independent of the dosage and early withdrawal of methylprednisolone (P > .05). Patients with methylprednisolone withdrawal within 6 months had significantly longer survival than those using methylprednisolone for more than 6 months (50 ± 15 vs 41 ± 18 mo; P = .007). Conclusions: Calcineurin-inhibitor-induced pain syndrome and osteonecrosis of the femoral head are main causes of hip pain in adult orthotopic liver transplant patients. Osteonecrosis of the femoral head was not common, but the incidence of hip pain owing to calcineurin-inhibitor-induced pain syndrome was relatively high in orthotopic liver transplant patients. Early withdrawal of methylprednisolone could benefit the patients' survival.

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“…Most patients with severe CF-related lung disease have reduced bone mass (115,116) . Recent reports suggest that defective bone mineralisation occurs in early childhood in individuals with CF (51,117) .…”

Section: Bone Healthmentioning

confidence: 99%

Symposium 6: Young people, artificial nutrition and transitional care The nutritional challenges of the young adult with cystic fibrosis: transition

Morton

2009

Proc. Nutr. Soc.

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Cystic fibrosis (CF) is a complex multisystem disorder affecting mainly the gastrointestinal tract and respiratory system. Intestinal malabsorption occurs in approximately 90 % of patients. In the past, malnutrition was an inevitable consequence of disease progression, leading to poor growth, impaired respiratory muscle function, decreased exercise tolerance and immunological impairment. A positive association between body weight and height and survival has been widely reported. The energy requirements of patients with CF vary widely and generally increase with age and disease severity. For many young adults requirements will be 120-150% of the age-related estimated average requirement. To meet these energy needs patients are encouraged to eat a high-fat high-energy diet with appropriate pancreatic enzyme supplements. Many patients are unable to achieve an adequate intake as a result of a variety of factors including chronic poor appetite, infection-related anorexia, gastro-oesophageal reflux and abdominal pain. Oral energy supplements and enteral tube feeding are widely used. Nutritional support has been shown to improve nutritional status and stabilise or slow the rate of decline in lung function. With such emphasis on nutritional intake and nutritional status throughout life, poor adherence to therapies and issues relating to body image are emerging. The median survival of patients with CF is increasing. CF is now considered a life-limiting disease of adulthood rather than a terminal childhood illness. With increased longevity new challenges are emerging that include the transition of young adults with CF to adult services, CF-related diabetes, disordered eating, osteoporosis, liver disease and transplantation.

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Osteoporosis in lung transplantation candidates with end-stage pulmonary disease

Cited by 218 publications

References 35 publications

COPD and Bone Loss

COPD and Bone Loss

Immunosuppressant-Related Hip Pain After Orthotopic Liver Transplant

Symposium 6: Young people, artificial nutrition and transitional care The nutritional challenges of the young adult with cystic fibrosis: transition

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