Changes in Bone Mineral Density after Kidney Transplantation

Abstract

Aim: The aim of this study was to evaluate changes in lumbar and femoral bone mineral density (BMD) in the post-transplant period.
Material and Methods: A total of 69 consecutive adult (>18 years of age) patients who underwent kidney transplantation between Jan 2016 and Jul 2019 were included in this retrospective study. The demographic features and laboratory findings of the patients (serum corrected calcium, phosphorus, alkaline phosphatase, creatinine, eGFR, i-parathormone and 25(OH) D vitamin levels) were recorded. BMD was evaluated by dual energy X-ray absorptiometry (DEXA).
Results: According to the DEXA results, lumbar and femoral T scores were -1.1±1.3 and -1.1±1.1, respectively. Lumbar assessment revealed osteoporosis in 12 (17.4%) patients and osteopenia in 24 (34.8%) patients. Femoral assessment revealed osteoporosis in 7 (10.1%) patients and osteopenia in 29 (42.0%) patients. The first year, 1-2 year and >2 years follow up data revealed osteoporosis in 4.3%, 5.8% and 7.2% of patients in the lumbar region and in 2.9%, 2.9% and 4.3% of patients in the femoral region, respectively. There was no significant difference in cumulative steroid dose between patients with BMD loss in the lumbar (p=0.197) and femoral (p=0.971) region and patients with normal BMD measurement. In addition, no significant relation was observed between the induction therapy and loss of BMD in the lumbar region (p=0.671) and femur (p=0.126).
Conclusion: As a result, 25(OH) D vitamin deficiency is quite common in transplant patients and the loss of BMD is observed especially in the lumbar region in the first year after transplantation.

Keywords

• Kidney transplantation,bone mineral density,lumbar region,femoral,vitamin D,vitamin D,vitamin D,vitamin D

Böbrek Nakli Sonrası Kemik Mineral Yoğunluğundaki Değişiklikler

Abstract

Amaç: Bu çalışmanın amacı böbrek nakil sonrası dönemde lomber ve femoral kemik mineral yoğunluğundaki (KMY) değişiklikleri değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif çalışmaya, Ocak 2016 ve Temmuz 2019 tarihleri arasında böbrek nakli yapılan ardışık 69 erişkin (>18 yaş) hasta dahil edildi. Hastaların demografik özellikleri ve laboratuvar bulguları (serum düzeltilmiş kalsiyumu, fosfor, alkalen fosfataz, kreatinin, eGFR, i-parathormon ve 25(OH) D vitamin düzeyi) ile ilgili veriler kaydedildi. KMY, dual enerji X-ray absorbsiyometri (DEXA) ile değerlendirildi.
Bulgular: DEXA sonuçlarına göre, lomber ve femoral T skorları sırasıyla -1,1±1,3 ve -1,1±1,1 idi. Lomber değerlendirmede 12 (%17,4) hastada osteoporoz ve 24 (%34,8) hastada osteopeni saptandı. Femoral değerlendirmede 7 (%10,1) hastada osteoporoz ve 29 (%42,0) hastada osteopeni saptandı. İlk yıl, 1-2 yıl ve >2 yıl takip verilerine göre, sırasıyla lomber bölgede hastaların %4,3, %5,8 ve %7,2’sinde, femurda hastaların %2,9, %2,9 ve %4,3’ünde osteoporoz saptandı. Lomber bölge (p=0,197) ve femurda (p=0,971) KMY kaybı tespit edilen hastalar ile KMY ölçümü normal olan hastalar arasında kümülatif steroid dozu açısından anlamlı bir fark yoktu. Ayrıca hastaların almış olduğu indüksiyon tedavisi ile lomber bölge (p=0,671) ve femurda (p=0,126) gelişen KMY kaybı arasında anlamlı bir ilişki görülmedi.
Sonuç: Sonuç olarak, nakil hastalarında 25(OH) D vitamini eksikliği oldukça yaygındır ve özellikle nakilden sonraki ilk yıl lomber bölgede belirgin olmak üzere KMY kaybı görülmektedir.

Keywords

• Böbrek nakli,kemik mineral yoğunluğu,lomber bölge,femur,vitamin D

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