[Relationship between aseptic necrosis of femoral head bone and immunosuppression therapy, especially CsA...

We reviewed 224 patients, who underwent kidney transplantation to investigate relationship between aseptic necrosis (AN) and administration of steroid, Cyclosporin A (CsA), body weight gain. We classified patients into 4 groups by the type of immunosuppressant: the AP group had received Azathioprine (AZ) + Prednisolone (Pre); the CP group, CsA + Pre; the ACP group, AZ + CsA + Pre; and others. There were total 24 AN patients (10.7%). The incidences of AN is 18% in the CP group, 9.3% in the AP group and 0% in the ACP group. In the AP group, weight gain at 1 and 2 month after transplantation and cumulative steroid dose at 3, 4, 5 and 6 month after transplantation correlated with AN. In the patients with AN of the CP and ACP groups, CsA doses per kilogram of body were higher than those in patients without AN at 5, 6 and 12 month after transplantation. In the CP group, the incidence of AN is significantly higher, and administration dose of CsA was higher than that in the ACP group. However steroid dose and body weight gain were lower in the CP group. Therefore AN was associated with CsA in the CP group. In contrast, AN correlated with weight gain and early high cumulative steroid dose administration in the AP group.