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Published on: April 28, 2013
Avascular osteonecrosis after renal transplantation
1Department of Internal Medicine A, Charles Nicolle Hospital, Tunis, Tunisia. hafedh.hedri@ms.tn
Transplantation Proceedings
|May 26, 2007
Summary
Avascular osteonecrosis (AVN) is a complication after kidney transplants. High steroid doses and acute rejection rates are linked to AVN, suggesting steroid reduction is key for prevention.
Area of Science:
- Nephrology
- Orthopedics
- Immunology
Background:
- Avascular osteonecrosis (AVN) is a significant complication following renal transplantation.
- Prevalence of AVN has decreased due to reduced steroid use and introduction of cyclosporine.
Purpose of the Study:
- To evaluate the frequency of AVN in kidney transplant recipients.
- To identify risk factors associated with AVN by comparing patients with and without the condition.
Main Methods:
- Retrospective analysis of 326 kidney transplant recipients (1986-2004).
- 15 patients with symptomatic AVN were compared to 15 matched controls without AVN.
- Diagnostic methods included X-ray, bone scan, and MRI; risk factors analyzed: donor type, dialysis duration, steroid dose, rejection rate, weight gain.
Main Results:
- AVN occurred in 4.6% of patients, diagnosed a mean of 3.5 years post-transplant, primarily affecting the femoral head.
- Higher cumulative steroid doses (P=.04) and acute rejection rates (P=.058) were observed in the AVN group.
- The main localizations were the femoral head (12 cases) and femoral condyle (3 cases).
Conclusions:
- Cumulative steroid dose and acute rejection rate are significant risk factors for AVN post-renal transplant.
- Reduction or early withdrawal of steroid therapy is the most effective preventive strategy for AVN.
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