title: Osteoarticular pain and bone mineral density in renal transplantation.
abstract: BACKGROUND
  The reduction of bone mineral density (BMD) levels is an important complication after renal transplantation. The prevalence of nontraumatic lesions may reach 22%. Patients with lower osseous mass suffer the highest number of lesions.
  
  
  OBJECTIVE
  Evaluate BMD in patients over 30-years old who have undergone renal transplantation more than 1 year prior, who attend a medical facility complaining of osteoarticular pain and were prescribed rest or any analgesia.
  
  
  METHODS
  One hundred twenty-three patients who received a renal transplant from a cadaveric donor from 1980 through 2000 were included in the present study to measure BMD levels in the hips and the vertebral column using a densitometer (Hologic 4500 QDR). Our study complied with WHO recommendations, which define normal values as a T score >-1 SD osteopenia as a (T score between <-1 and >-2.5 SD), and osteoporosis as a T score <-2.5 SD. Patients were divided into three groups according to gender and hormonal status. The following clinical and analytic data were collected: age, gender, race, age at onset of menopause, diabetes mellitus (DM), weight, size, retransplantation, period of evolution after transplantation, and parathormone (PTH), creatinine, and renal clearance values.
  
  
  RESULTS
  There were 51 men (41.1%) included. Forty postmenopausal (32.5%) and premenopausal women (26%) were also included. In all patients we observed a correlation between a reduction in BMD values and age, duration post-transplantation, and body weight (P<.05). Reduced BMD levels in premenopausal women were related with lower body weight, (P<.05) and elevated PTH levels (P<.024).
  
  
  CONCLUSIONS
  We observed that patients who had undergone transplantation displayed a moderately higher risk of suffering a fracture. Such risk increased in the case of women with more frequent fractures in the vertebral column. In 23.8% of patients reporting osseous pain, there was no reduction in BMD levels. Therefore, we must look for other disorder, responsible for the pain and prescribe adequate treatment.
authors.affiliation: Unit of Nephrology, University Hospital Virgen del Rocio, Seville, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Toro
authors.forename: M A
authors.initials: MA
authors.lastname: Gentil
authors.forename: R
authors.initials: R
authors.lastname: García
authors.forename: R
authors.initials: R
authors.lastname: Alvárez
authors.forename: M A
authors.initials: MA
authors.lastname: Valdivia
authors.forename: F G
authors.initials: FG
authors.lastname: Roncero
authors.forename: P
authors.initials: P
authors.lastname: Pereira
authors.forename: G
authors.initials: G
authors.lastname: Algarra
authors.forename: J
authors.initials: J
authors.lastname: Mateos
mesh_terms: D000328:Adult; D001835:Body Weight; D015519:Bone Density / Q000502:physiology*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000453:epidemiology / Q000503:physiopathology*; D010024:Osteoporosis / Q000453:epidemiology; D010146:Pain; D017698:Postmenopause; D017697:Premenopause; D012189:Retrospective Studies; D012307:Risk Factors