title: Bone alterations in children and young adults with renal transplant assessed by phalangeal quantitative ultrasound.
abstract: BACKGROUND
  Bone alterations in young renal transplant recipients were investigated in several studies with conflicting results. Quantitative ultrasound of the phalanges is a recently developed noninvasive procedure to assess skeletal status.
  
  
  METHODS
  Cross-sectional study at a single transplant center with values compared with previously studied healthy controls.
  
  
  METHODS
  40 children and young adult recipients of renal grafts (15 females, 25 males; age, 20.0 +/- 8.4 years) studied 7.1 +/- 3.8 years after kidney transplantation.
  
  
  METHODS
  Clinical, biochemical, and therapeutic features, including calcium, phosphate, and intact parathormone levels; and cumulative dosages of glucocorticoids and cyclosporine administered since transplantation.
  
  
  METHODS
  Phalangeal quantitative ultrasound, including amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), mainly dependent on mineral density and cortical thickness, respectively. Age- and sex-matched healthy controls were used to provide age-related z scores; sex- and height-matched healthy subjects, to provide z scores related to statural age.
  
  
  RESULTS
  Mean z scores of AD-SoS and BTT were -0.05 +/- 1.59 and -0.54 +/- 1.17, respectively (P > 0.05 and P < 0.001, respectively). Multivariate analysis showed that AD-SoS z score was associated significantly with body mass index, intact parathormone level, cumulative glucocorticoids administered in the first posttransplantation year, and cyclosporine administered since transplantation (model r(2) = 0.79; P < 0.001); BTT z score was associated significantly with glucocorticoid dosage in the first posttransplantation year and age (model r(2) = 0.55; P < 0.001).
  
  
  CONCLUSIONS
  Absence of other measures of bone structure and longitudinal measures and comparison to a noncurrent control group.
  
  
  CONCLUSIONS
  Children and young adults may have decreased cortical thickness with maintained overall mineral density after renal transplantation. The findings of phalangeal quantitative ultrasound parallel observations using other imaging techniques. Phalangeal quantitative ultrasound may be a useful method to assess bone alternations after renal transplantation.
authors.affiliation: Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Torino, Italy. mussa_alessandro@yahoo.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mussa
authors.forename: Francesco
authors.initials: F
authors.lastname: Porta
authors.forename: Bruno
authors.initials: B
authors.lastname: Gianoglio
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gaido
authors.forename: Mario Guido
authors.initials: MG
authors.lastname: Nicolosi
authors.forename: Francesca
authors.initials: F
authors.lastname: De Terlizzi
authors.forename: Carlo
authors.initials: C
authors.lastname: de Sanctis
authors.forename: Rosanna
authors.initials: R
authors.lastname: Coppo
mesh_terms: D000293:Adolescent; D000328:Adult; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D014463:Ultrasonography