[Skeletal changes in the kidney transplant patient].
The skeletal status was investigated with noninvasive diagnostic procedures in 44 renal transplant patients (mean time since intervention: 5 to 195 months) treated with steroid and azathioprine (21 cases) or with steroid, azathioprine and cyclosporine (23 cases). 38.6% of the patients had reduced renal function (creatininemia: 1.6-3.0 mg/dl). Our patients underwent biochemical and hormonal tests of bone metabolism, digital radiographs of the skeleton and bone mineral density measurement with dual-energy X-ray absorptiometry (DXA, Hologic QDR 1000). All the patients exhibited moderate to severe osteopenia at both radiographic and densitometric investigations; the risk of fracture was high in 47% of cases. Radiographic signs of vertebral fractures were observed in 4.5% of cases. Other major radiographic patterns were the aseptic necrosis of femoral head (9%), of carpal bone (4.5%) and of humeral head (2.2%). Fibrous osteitis was demonstrated in three patients. Geodes in the wrist were also observed. The correlation of bone densitometry values and time since renal transplantation was statistically significant (r = 0.381; p < 0.01). Moreover, the grade of osteopenia correlated with serum levels of calcitonin and calcitriol--the latter especially in the patients with severe osteopenia.
Orzincolo
C
C
Servizio di Radiologia e Medicina Nucleare, Arcispedale S. Anna, Ferrara.
Bagni
B
B
Bedani
P L
PL
Ghedini
M
M
Scutellari
P N
PN
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000000981:diagnostic imaging* / Q000502:physiology / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D011856:Radiographic Image Enhancement; D012307:Risk Factors; D013997:Time Factors
Alterazioni scheletriche nel paziente con trapianto renale.