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[Skeletal changes in the kidney transplant patient]
C Orzincolo1, B Bagni, P L Bedani
1Servizio di Radiologia e Medicina Nucleare, Arcispedale S. Anna, Ferrara.
La Radiologia Medica
|June 1, 1994
Summary
Renal transplant patients frequently experience significant bone loss (osteopenia) and fracture risk, with bone density correlating to time since transplant and hormone levels. This highlights the need for monitoring skeletal health post-transplantation.
Area of Science:
- Nephrology
- Endocrinology
- Radiology
Background:
- Renal transplantation is a common treatment for end-stage renal disease.
- Patients undergoing renal transplantation often experience complications affecting bone metabolism.
- Immunosuppressive therapies, including steroids, azathioprine, and cyclosporine, can impact skeletal integrity.
Purpose of the Study:
- To assess the skeletal status of renal transplant recipients.
- To evaluate the prevalence of bone abnormalities and fracture risk in this population.
- To investigate correlations between bone health, immunosuppressive therapy, and biochemical markers.
Main Methods:
- Noninvasive diagnostic procedures were used in 44 renal transplant patients.
- Methods included biochemical and hormonal tests, digital radiography, and dual-energy X-ray absorptiometry (DXA).
- Patients were categorized based on immunosuppressive regimens (steroid/azathioprine vs. steroid/azathioprine/cyclosporine).
Main Results:
- All patients exhibited moderate to severe osteopenia.
- 47% had a high risk of fracture, with vertebral fractures in 4.5%.
- Aseptic necrosis and fibrous osteitis were observed; bone density correlated with time since transplant and calcitriol levels.
Conclusions:
- Renal transplant recipients commonly develop significant osteopenia and face a high fracture risk.
- Skeletal status is influenced by the duration post-transplantation and specific hormone levels.
- Regular monitoring of bone metabolism and density is crucial for managing renal transplant patients.