Prevalence of Osteoporosis in Patients After Renal Transplantation: Results from a Single Center

Abstract

Osteopenia and bone loss are major complications after renal transplantation. Clinical data in the Asian population are lacking. We prospectively studied the changes in bone mineral density (BMD) of 31 cadaveric renal allograft recipients using dual energy X-ray absorptiometry (DEXA) within 2 weeks after transplantation and then at 1 year post transplantation. One year after transplantation, the mean bone mineral reduction at the lumbar spine was 6.3 ± 4.9% (osteopenia in 32.2% of patients and osteoporosis in 6.5%). For the femoral neck, there was a 4.3 ± 5.5% decrease in BMD (osteopenia in 38.7% of patients and osteoporosis in 3.2%). For total hip, there was a 4.8 ± 3.6% decrease in BMD (osteopenia in 25.8% of patients and osteoporosis in 3.2%). Decrease in BMD at the femoral neck and total hip correlated with the cumulative dosage of steroid (femoral neck: r = −0.36, p = 0.048; total hip: r = −0.4, p = 0.026). Compared with patients without rejection, patients with a history of acute rejection received higher cumulative doses of steroid, and sustained a greater decrease in BMD at the femoral neck and total hip: median percentage (interquartile range) decrease in femoral neck BMD was 7.7% (−12.8 to −6.3) versus 4.4% (−6.5 to −0.065), p = 0.016; decrease in total hip BMD was 8.2% (−11.22 to −6.7) versus 3.4% (−6.92 to −1.4), p = 0.03. There was no correlation between BMD changes and cumulative dosage of cyclosporine A, azathioprine, tacrolimus, duration of dialysis, changes in body mass index, creatinine or parathyroid hormone levels. Reduction of BMD after renal transplantation is common. The cumulative dosage of prednisolone correlates with bone loss at the femoral neck and total hip. Patients with a history of acute rejection suffered from more bone loss after 1 year compared to patients without rejection.