1007 Osteoporosis and Bone Disorders in Paediatric Renal Transplantation Recipients

Abstract

Decreased bone mineral density (BMD) is common in renal transplantation recipients (RTR). Osteoporosis has a major role in morbidity in these patients. Risk factors for decreased bone mass include underlying renal disease, nutritional deficits, decreased physical activity, inflammation and immunosuppressive therapy.We assessed the prevalence of osteoporosis and risk factors for bone disease in patients with at least 6 moths post renal transplantation. The patients underwent clinical and laboratory evaluation, dualenergy X- ray absorptiometry (DXA) for BMD in lumbar spine (LS) and femoral neck. Low bone mineral density was defined by lumbar spine Z-scores less than or equal to -2 on DXA using the equipment-specific age, sex- and ethnicity - adjusted.The study included 24 subjects who were between 7 and 18 years of age. The incidence of osteoporosis was 25% (6/24). We found 6 patients, all teenagers, 4/6 boys. Other bone disorders were 1 child with bone fracture, 1 genu valgum submitted to surgery and 1 femoral head avascular necrosis, but without osteoporosis diagnosed.Four patients had PTH value >100 ng/liter, one of these with LS Z-score less than (-2). All were on triple drug immunosuppression with prednisolone, tacrolimus and mycophenolate mofetilIn conclusion, although DXA has several limitations it remains a good method for non-invasive and reproducible BMD assessment in children and young adults. Osteoporosis is a frequent complication and requires detection and treatment to reduce morbidity. The prevention of bone disorders is very important.