Incidence of hip osteonecrosis among renal transplantation recipients: a prospective study.
OBJECTIVE
To investigate whether a lessened glucocorticoid cumulative dose would lead to a decreased incidence of femoral head osteonecrosis.


METHODS
Newly transplanted in-patients (n = 49) underwent hip radiographs and magnetic resonance imaging (MRI) a mean of 17.0+/-4.3 (range 8-29) days after renal transplantation. For the 48 patients without evidence of prevalent osteonecrosis, imaging at a mean of 5.9+/-0.8 (range 4.8-8.7) months after renal transplantation was graded for presence/absence of femoral head osteonecrosis by two blinded radiologists. Sociodemographic and disease characteristics of patients were compared to identify potential associations with incident osteonecrosis.


RESULTS
At 6-month follow-up, only two patients (4%) had osteonecrosis of the femoral head (three hips). The two primary radiologists had excellent agreement between osteonecrosis diagnosis (kappa coefficient=0.78). Both cases of a definite MRI diagnosis of osteonecrosis occurred in patients who were in the highest tertile of glucocorticoid dosage.


CONCLUSIONS
Osteonecrosis was uncommon among a prospective cohort of renal transplant recipients within 6 months after engraftment.
Lopez-Ben
R
R
Departments of Radiology and Medicine, University of Alabama School of Medicine and Hospitals, Birmingham, AL 35249-3408, USA.
Mikuls
T R
TR
Moore
D S
DS
Julian
B A
BA
Bernreuter
W K
WK
Elkins
M
M
Saag
K G
KG
D015331:Cohort Studies; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis; D006621:Hip Joint; D006801:Humans; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000175:diagnosis*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods