Risk factors for nontraumatic osteonecrosis of the femoral head after renal transplantation.
We investigated risk factors for osteonecrosis of the femoral head (ONF) in renal transplant recipients, who are susceptible to the disease. Among 287 renal transplant recipients, 18 ONF patients with enough data were included, and 18 age- and sex-matched recipients without ONF were nominated as reference cases. Risk factors were analyzed using a conditional logistic regression method. There were no differences between the ONF patients and the reference cases regarding the types of immunosuppressant or the donor (living or cadaveric, father or mother, matching blood type and human leukocyte antigens). The daily oral steroid dosage (prednisolone 25.0 mg/day or more) and blood urea nitrogen level 2 months after transplantation were the only factors with relevance to the occurrence of ONF. We propose that oral steroid dosages should be low or reduced after renal transplantation, and acute rejection should be controlled with pulsed therapy.
Inoue
Shigehiro
S
Department of Orthopaedic Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-0841, Japan.
Horii
Motoyuki
M
Asano
Takeshi
T
Fujioka
Mikihiro
M
Ogura
Taku
T
Shibatani
Masahiko
M
Kim
Wook-Choel
WC
Nakagawa
Masako
M
Tanaka
Takashi
T
Hirota
Yoshio
Y
Kubo
Toshikazu
T
D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D005260:Female; D005271:Femur Head Necrosis / Q000453:epidemiology* / Q000209:etiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D011336:Probability; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014181:Transplantation Immunology
D011239:Prednisolone