بررسي تراكم استخوان در بيماران با نارسايي كليه قبل و بعد از پيوند كليه

Assessment of Bone Density in Patients before and after Kidney Transplantation

Accentuation of bone loss is one of the most important skeletal complications after transplantation. Early diagnosis and treatment of osteopenia and osteoporosis reduce risk of fractures and prevent the aggravation of it by using corticosteroid after kidney transplantation. Materials and Methods A total of 50 patients that received graft during the research time, 31 of them completed it. They were screened for decreased bone mineral density at baseline, 6 and 12 months after transplantation with dual-energy x-ray absorptiometry (DEXA) of lumbar spine and hip. Results A total of 31 patients [17 (55.8%) female and 14 (45.2%) male] with end stage renal disease entered the study. The mean age of patients in both genders were 39.67±14.5 years (range: 20-67years). Replacement therapy in 24 patients (77.4%) was hemodialysis and in 7 patients (22.6%) was peritoneal dialysis. Before transplantation, the mean of T-score in femoral neck and lumbar vertebra were - 0.88±1.19 and-0.37±1.12 respectively, osteopenia was found in 41.9% and 29% of each region. On 6 months after transplantation, the mean of T-score in femoral neck and lumbar vertebra -1.42±0.95 and -1.41=bl.36 respectively. Incidence of osteopenia in each region was 83.9% and 64.5% in turn. We tried to examine them in the first year after transplantation, the mean of T-score in femoral neck was- 1.13±1.11 and in lumbar vertebra was -1.29±1.33. After 6 months, bone mass reduction was significant (p<0.05), but there was not any significant difference between 6 and 12 months following transplantation (p>0.05). Conclusion Bone loss was highest in the first 6 months after transplantation. Then, treatment was necessary during this period of time.