Download PDF
Horm Metab Res 2009; 41(7): 563-567
DOI: 10.1055/s-0029-1214387
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Spine Bone Mineral Density in Subjects after Renal Transplantation Compared with End-stage Renal Failure and Healthy Subjects

W. Pluskiewicz 1 , J. Zywiec 2 , J. Gumprecht 2
  • 1Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland
  • 2Department and Clinic of Internal Diseases, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland
Further Information

Publication History

received 03.09.2008

accepted 04.02.2009

Publication Date:
02 April 2009 (online)

Also available at
    Permissions and Reprints

Abstract

The aim of the study was to assess spine bone mineral density in 160 dialyzed subjects with end-stage renal failure, 81 patients after renal transplantation, and 148 controls. Spine bone mineral density [g/cm2] was measured by Lunar DPX-L (USA). Data analyses were performed using Statistica for Windows. In gender subgroups Z-score were significantly lower after transplantation than in controls (p<0.001), but not in subjects on dialysis. The mean value of Z-score in subjects after transplantation was significantly lower than in dialyzed patients. Z-score both in transplanted and dialyzed males were significantly lower than in females. Duration of dialysis, time since transplantation, and cumulative dose of steroids did not associate with values of spine bone mineral density (except for the negative association with dialysis duration time in males). In patients after transplantation, multiple stepwise regression analysis of spine bone mineral density and age, body size, parathormone, duration of dialysis, time after transplantation, and cumulative dose of steroids after transplantation have shown negative role of steroids use and positive role of parathormone and bone mass in males. Spine bone mineral density in dialyzed subjects was not decreased as compared with controls while the aggravation in skeletal status was observed after renal transplantation.

Key words

dialysis - renal - transplantation - Z-score

References

  • 1 Malluche HH, Ritz E, Lange HP, Kutschera L, Hodgson M, Seiffert U, Schoeppe W. Bone histology in incipient and advanced renal failure.  Kidney Int. 1976;  9 355-362
    Search in Google Scholar
  • 2 Sanchez CP. Prevention and treatment of renal osteodystophy in children with chronic renal insufficiency and end- stage renal disease.  Semin Nephrol. 2001;  21 441-450
    Search in Google Scholar
  • 3 Rix M, Andreassen H, Eskildsen P, Langdahl B, Olgaard K. Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure.  Kidney Int. 1999;  56 1084-1093
    Search in Google Scholar
  • 4 Przedlacki J, Pluskiewicz W, Wieliczko M, Drozdowska B, Matuszkiewicz-Rowinska J, Bogdanska-Straszynska B, Wlodarczyk B, Ostrowski K. Quantitative ultrasound of phalanges and dual-energy X-ray absorptiometry of forearm and hand in patients with end-stage renal failure treated with dialysis.  Osteoporos Int. 1999;  10 1-6
    Search in Google Scholar
  • 5 Taal M, Masud T, Green D, Cassidy MJD. Risk factors for reduced bone density in haemodialysis patients.  Nephrol Dial Transplant. 1999;  14 1922-1928
    Search in Google Scholar
  • 6 Zayour D, Daouk M, Salamoun M, El-Hajj Fuleihan G. Predictors of bone mineral density in patients on hemodialysis.  Transpl Proc. 2004;  36 1297-1301
    Search in Google Scholar
  • 7 Lacativa PG, de Mendonca LM, de Mattos Patricio, Filho PJ, Pimentel JR, da Crus Goncalves MD, Fleiuss de Farias ML. Risk factors for decreased total body and regional bone mineral density in hemodialysis patients with severe secondary hyperparathyroidism.  J Clin Densitom. 2005;  8 352-361
    Search in Google Scholar
  • 8 Roe SD, Porter CJ, Godber IM, Hosking DJ, Cassidy MJ. Reduced bone mineral density in male renal transplant recipients: evidence for persisting hyperparathyroidism.  Osteoporos Int. 2005;  16 142-148
    Search in Google Scholar
  • 9 Julian BA, Laskow DA, Dubovsky J, Dubovsky EV, Curtis JJ, Quarles LD. Rapid loss of vertebral mineral density after renal transplantation.  N Eng J Med. 1991;  325 544-550
    Search in Google Scholar
  • 10 Horber FF, Casez JP, Steiger U, Czerniak A, Montandon A, Jaeger P. Changes in bone mass early after kidney transplantation.  J Bone Miner Res. 1994;  9 1-9
    Search in Google Scholar
  • 11 Baylink DJ. Glucocorticoid-induced osteoporosis.  N Eng J Med. 1983;  309 306-308
    Search in Google Scholar
  • 12 Walpaw T, Deal CL, Fleming-Brooks S, Bartucci MR, Schulak JA, Hricik DE. Factors influencing vertebral bone density after renal transplantation.  Transplantation. 1994;  58 1186-1189
    Search in Google Scholar
  • 13 Thiebaud D, Krieg MA, Gillard-Berguer D, Jacquet AF, Goy JJ, Burckhardt P. Cyclosporine induces high bone turnover and may contribute to bone loss after heart transplantation.  Eur J Clin Invest. 1996;  26 549-555
    Search in Google Scholar
  • 14 Grotz WH, Mundinger A, Gugel B, Exner V, Kirste G, Schollmeyer PJ. Bone fracture and osteodensitometry with dual energy X-ray absorptiometry in kidney transplant recipients.  Transplantation. 1994;  58 912-915
    Search in Google Scholar
  • 15 Bagni B, Gilli P, Cavallini A, Bagni I, Marzola MC, Orzincolo C, Wahner HW. Continuing loss of vertebral mineral density in renal transplant recipients.  Eur J Nucl Med. 1994;  21 108-112
    Search in Google Scholar
  • 16 Torregrosa JV, Campistol JM, Montesions M, Pons F, Martinez de Osaba DJ, Oppenheimer F. Factors involved in the loss of bone mineral density after renal transplantation.  Transpl Proc. 1995;  27 2224-2225
    Search in Google Scholar
  • 17 Pichette V, Bonnardeux A, Prudhomme L, Gagne M, Cardinla J, Quimet D. Long-term bone loss in kidney transplant recipients: a cross-sectional and longitudinal study.  Am J Kidney Dis. 1996;  28 105-114
    Search in Google Scholar
  • 18 Aroldi D, Tarantino A, Montagnino G, Cesana B, Cocucci C, Ponticelli C. Effects of three immunosupressive regimens on vertebral bone mineral density in renal transplant recipients: a prospective study.  Transplantation. 1997;  63 380-386
    Search in Google Scholar
  • 19 Caglar M, Adeera L. Factors affecting bone mineral density in renal transplant recipients.  Ann Nucl Med. 1999;  13 141-145
    Search in Google Scholar
  • 20 Parker CR, Freemont AJ, Blackwell PJ, Grainge MJ, Hosking DJ. Cross-sectional analysis of renal transplantation osteoporosis.  J Bone Miner Res. 1999;  14 1943-1951
    Search in Google Scholar
  • 21 Cueto-Manzano AM, Konel S, Hutchison AJ, Crovley V, France MW, Freemont AJ, Adams JE, Mawer B, Gokal R. Bone loss in long-term renal transplantation: histopathology and densitometry analysis.  Kidney Int. 1999;  55 2021-2029
    Search in Google Scholar
  • 22 D’Angelo A, Calo L, Giannini S, Carraro G, Bonfante L, Favaro S, Zaninotto M, Perin N, Di Landro D, Riqotti P, Antonello A. Parathyroid hormone and bone metabolism in kidney-transplanted patients.  Clin Nephrol. 2000;  53 19-22
    Search in Google Scholar
  • 23 Carlini RG, Rojas E, Weisinger JR, Lopez M, Martinis R, Arminio A, Bellorin-Font E. Bone disease in patients with long-term renal transplantation and normal renal function.  Am J Kidney Dis. 2000;  36 160-166
    Search in Google Scholar
  • 24 Kokado Y, Takahara S, Ichimaru N, Toki K, Kyo M, Permpongkosol S, Kojima Y, Inoue T, Wang JD, Okuyama A. Factors influencing vertebral bone mineral density after renal transplantation.  Transpl Int. 2000;  13 ((Suppl 1)) 43-S435
    Search in Google Scholar
  • 25 Patel S, Kwan JT, MacCloskey E, MacGee G, Thomas G, Johnson D, Wills R, Ogunremi L, Barron J. Prevalence and causes of low bone mineral density and fractures in kidney transplant patients.  J Bone Miner Res. 2001;  16 1863-1870
    Search in Google Scholar
  • 26 Durieux S, Mercadal L, Orcel P, Dao H, Rioux C, Bernard M, Rozenberg S, Barrou B, Bourgeois P, Deray G, Bagnis CI. Bone mineral density and fracture prevalence in long-term kidney graft recipients.  Transplantation. 2002;  27 496-500
    Search in Google Scholar
  • 27 Cesez JP, Lippuner K, Horber FF, Montandon A, Jaeger P. Changes in bone mineral density over 18 months following kidney transplantation: the respective roles of prednisone and parathyroid hormone.  Nephrol Dial Transplant. 2002;  17 1318-1326
    Search in Google Scholar
  • 28 Miklus TR, Julian BA, Bartolucci A, Saag KG. Bone mineral density changes within six months of renal transplantation.  Transplantation. 2003;  75 49-54
    Search in Google Scholar
  • 29 Brandenburg VM, Politt D, Ketteler M, Fassbender WJ, Heussen N, Westenfeld R, Freuding T, Floege J, Ittel TH. Early rapid loss followed by long-term consolidation characterizes the development of lumbar bone mineral density after kidney transplantation.  Transplantation. 2004;  77 1566-1571
    Search in Google Scholar
  • 30 Techawathanawanna N, Avihingsanon Y, Praditpornsipla K, Tingpetch K, Suwanwalaikorn S, Kanjanabuch T, Eiam-Ong S, Tungsanga K. The prevalence and risk factors of osteoporosis in Thai renal-transplant patients.  J Med. Assoc Thai. 2005;  88 ((Suppl 4)) S103-S109
    Search in Google Scholar
  • 31 Roe SD, Porter CJ, Godber IM, Hosking DJ, Cassidy MJ. Reduced bone mineral density in male renal transplant recipients: evidence for persisting hyperparahtyroidism.  Osteoporosis Int. 2005;  16 142-148
    Search in Google Scholar
  • 32 Brandenburg VM, Ketteler M, Heussen N, Politt D, Frank RD, Westenfeld R, Ittel TH, Floege J. Lumbar bone mineral density in very long-term renal transplant recipients: impact of circulating sex hormones.  Osteoporos Int. 2005;  16 1611-1620
    Search in Google Scholar
  • 33 Akaberi S, Lingergard B, Simonsen O, Nyberg G. Impact of parathyroid hormone on bone mineral density in long-term renal transplant patients with good graft function.  Clinical Transplantation. 2006;  82 749-752
    Search in Google Scholar
  • 34 Gallego R, Oliva E, Vega N, Ojeda S, Hortal L, Hernandez FF, Fernandez A, Eisman A, Silva D, Palop L. Steroids and bone mineral density in patients with functioning kidney allografts.  Transplant Proc. 2006;  38 2434-2437
    Search in Google Scholar
  • 35 Bolotin HH, Sievanen H. Innaccuracies inherent in dual-energy X-ray absorptiometry in vivo bone mineral density can seriously mislead diagnostic/prognostic interpretation of patients-specific bone fragility.  J Bone Miner Res. 2001;  16 799-805
    Search in Google Scholar

Correspondence

J. Zywiec

Department and Clinic of Internal DiseasesDiabetology and Nephrology

Medical University of Silesia

3-Maja Str. 13–15

Zabrze 41-800

Poland

Phone: +48/32/271 25 11

Fax: +48/32/271 46 17

Email: jzywiec@sum.edu.pl