Bone Density Reduction and Its Associated Factors in Kidney Transplant Recipients: A Cross-Sectional Study

Decreased bone mineral density (BMD) is one of the complications of kidney transplantation, which is associated with many factors. However, the findings of relevant studies are inconsistent and contradictory.

To investigate the prevalence of BMD reduction and its associated factors in kidney transplant recipients.

All kidney transplant recipients (n=69), referred to Shahid Mostafa Khomeini Hospital in Ilam, southwest of Iran, were included in this study between 2016 and 2018. The BMD of the lumbar spine and femoral neck was examined using dual-energy X-ray absorptiometry. According to the Z-score and T-score, the patients were divided into two age groups: <50 years and >50 years. All patients' demographic characteristics, background variables, and laboratory parameters were evaluated. Descriptive statistics were measured, and binary and multinomial logistic regression analyses were performed.

The overall prevalence of osteoporosis in the femur and lumbar spine was 38% and 32%, respectively. In patients aged <50 years, femoral head osteoporosis showed a significant relationship with the vitamin D level and sex. In patients aged >50 years, advancing age and duration of prednisolone consumption were associated with an increased risk of osteoporosis and osteopenia at the femoral neck (P<0.05). Besides, the duration of prednisolone use was associated with osteoporosis at the lumbar spine (RRR=1.02, P<0.05).

Various factors, including prednisolone consumption, affect BMD reduction in kidney transplant recipients. Regular monitoring of BMD, maximum reduction of prednisolone dose, training on the use of effective supplements, and other preventive and supportive measures can be helpful for this group.