Prevalence of Asymptomatic Avascular Necrosis of the Hip in Patients With Kidney Transplantation

Abstract

Introduction: Kidney transplant is one of the treatments in patients with ESRD (end stage renal disease) that increases the quality of life in patients. Following kidney transplant, patients need glucocorticoid and immunosuppressant drugs. These drugs put patients in risk of hip avascular necrosis. The purpose of this study was to evaluate the prevalence of asymptomatic avascular necrosis of the hip in patients with kidney transplantation. Methods: This prospective descriptive cross-sectional study was conducted on all patients referred to the Shahid Mohammedi Hospital, Bandar Abbas, Iran, who had a kidney transplant at least six month before our study. All patients' information was collected with a questionnaire consisting of demographic information including age, sex, weight, height, history of hemodialysis, history of peritoneal dialysis, history of smoking, alcohol intake, history of prednisolone and the main variable data of the disease, including the causes of ESRD such as diabetes, hypertension and diabetes combined, polycystic kidney disease, IgA nephropathy reflux disease, focal segmental glomerulonephritis and time elapsed after the transplant. Magnetic resonance imaging (MRI) was used for the detection of avascular necrosis. Diagnosis of avascular necrosis was confirmed by two separate radiologists. Data was analyzed using IBM SPSS 21.0 software. Results: In this study, 83 patients were studied. Among these patients, 45 (54.2%) were male and 38 (45.8%) were female. The average age of the subjects was 41.29 ± 13.72 years. Demographic variables were similar in two groups. There was no relation among the vertebrae and overall results densitometry with avascular necrosis (p>0.05) . Based on this chart, prevalence of avascular necrosis in patients with osteoporotic hip based on densitometry, was significantly more than other people (p = 0.008). Conclusion: According to results, prevalence of femoral head avascular necrosis is not higher in patients after transplant and it has no significant relation to age, sex, BMI, time passed after transplant, CMV infection, hospitalization, history of dialysis or type of donator. Also, there was no significant correlation between the vertebra densitometry and the overall results of densitometry with avascular necrosis on MRI. The only factor associated with avascular necrosis in this study, was osteoporosis in the hip densitometry.