Abstract
Background. Renal transplantation (Tx) influences bone mineral density (BMD) by several mechanisms. The main objective of this study was to correlate BMD and risk factors associated with bone loss in patients submitted to kidney Tx. Methods. We evaluated 88 individuals after renal Tx (median time = 31.5 months since Tx). All of them sustained glomerular filtration rate ≥60 mL/min/1.73 m2. BMD was measured by dual-energy X-ray absorptiometry (DXA, Prodigy-GE). Calcium, phosphate, albumin, creatinine, and intact parathormone (PTH) were measured at the same time. All statistical tests were two-sided and P value less than 0.05 were accepted as significant for all analyses in this study. Results. Serum PTH was raised in 42% patients, but corrected calcium was normal in 83 patients. No fragility fracture was reported, but the overall prevalence of osteoporosis was 27.6% and lower than expected BMD (Z-score ≤ −2.0 SD) was observed in 28.4%. Patients with lower than expected BMD had higher PTH levels. Conclusions. Older age, lower body mass index (BMI), longer time on dialysis, and elevated PTH levels were identified as the main factors associated with lower BMD.
Highlights
Chronic kidney disease is caused by several conditions and has become a prevalent comorbidity
This was a cross-sectional study of patients submitted to kidney Tx and regularly seen as outpatients at the Clementino Fraga Filho Hospital, Federal University of Rio de Janeiro
Arterial hypertension was the main cause of renal failure (40%) followed by undefined etiology (22%), polycystic kidneys (7%), glomerulonephritis (6%), systemic lupus (4%), Table 2: Comparisons between patients who received kidney transplant from living or deceased donors
Summary
Chronic kidney disease is caused by several conditions and has become a prevalent comorbidity. Advances in immunosuppressive agents and transplant techniques during the last decades have led to improved long-term graft and patient survival. This fact resulted in both increases in transplant numbers and an increased recognition of previously neglected longterm complications of Tx, such as osteoporosis and fractures. Rates of bone loss are greatest during the first 6–18 months after renal Tx and range from 4 to 9% at the spine and 5 to 8% at the Advances in Endocrinology. The main objective of this study was to correlate BMD and risk factors associated with bone loss in patients submitted to kidney Tx. Methods. Lower body mass index (BMI), longer time on dialysis, and elevated PTH levels were identified as the main factors associated with lower BMD
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