Abstract
Background and Objectives: The musculoskeletal (MSK) manifestations in the kidney transplant recipient (KTxR) could lead to decreased quality of life and increased morbidity and mortality. However, the prevalence of these MSK manifestations is still not well-recognized. This review aimed to investigate the prevalence and outcomes of MSK manifestations in KTxR in the last two decades. Materials and Methods: Research was performed in EBSCO, EMBASE, CINAHL, PubMed/MEDLINE, Cochrane, Google Scholar, PsycINFO, Scopus, Science Direct, and Web of Science electronic databases were searched during the years 2000–2020. Results: The PRISMA flow diagram revealed the search procedure and that 502 articles were retrieved from the initial search and a total of 26 articles were included for the final report in this review. Twelve studies reported bone loss, seven studies reported a bone pain syndrome (BPS) or cyclosporine-induced pain syndrome (CIPS), and seven studies reported hyperuricemia (HU) and gout. The prevalence of MSK manifestations in this review reported as follow: BPS/CIPS ranged from 0.82% to 20.7%, while bone loss ranged from 14% to 88%, and the prevalence of gout reported in three studies as 7.6%, 8.0%, and 22.37%, while HU ranged from 38% to 44.2%. Conclusions: The post-transplantation period is associated with profound MSK abnormalities of mineral metabolism and bone loss mainly caused by corticosteroid therapy, which confer an increased fracture risk. Cyclosporine (CyA) and tacrolimus were responsible for CIPS, while HU or gout was attributable to CyA. Late diagnosis or treatment of post-transplant bone disease is associated with lower quality of life among recipients
Highlights
Kidney transplantation has been proven as a gold standard therapy for end-stage renal disease
A total of 26 articles were included for the final report; 12 studies reported bone loss, 7 studies reported bone pain syndrome (BPS)/cyclosporine-induced pain syndrome (CIPS), and 7 studies reported HU and gout
This review identified the full spectrum of musculoskeletal complications, for the first time, in this steadily increasing kidney transplant population
Summary
Kidney transplantation has been proven as a gold standard therapy for end-stage renal disease. The prevalence of musculoskeletal (MSK) manifestations, especially bone symptoms, is relatively high in kidney transplant recipients (KTxR) leading to decreased quality of life and increased morbidity and mortality. Other studies reported them as transient osteoporosis, stress fractures, persistent hyperparathyroidism (pHPTH)-induced bone diseases, osteonecrosis, soft tissue infections, and osteomalacia [3,7,8,9,10]. Those post-KTx bone diseases occur in adults, as well as in children and adolescences [11,12]. The musculoskeletal (MSK) manifestations in the kidney transplant recipient (KTxR) could lead to decreased quality of life and increased morbidity and mortality. Late diagnosis or treatment of post-transplant bone disease is associated with lower quality of life among recipients
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