Corticosteroid administration within 2 weeks after renal transplantation affects the incidence of femoral head osteonecrosis.
OBJECTIVE
It has been suggested that avascular osteonecrosis (AVN) of the femoral head occurs early after systemic steroid administration. The purpose of this study was to investigate the risks regarding development of AVN at a very early stage after renal transplantation.


METHODS
The presence or absence of AVN was determined by MRI at 4 weeks, at 6-12 weeks, at 24 weeks, and at 12 months after renal transplantation in 286 patients (183 males) with a mean age of 39 (16-65) years. The relationship between AVN and age, sex, absence or presence of acute rejection (AR), type of transplanted kidney (living or cadaveric), type of immune suppressor, and total dose of orally administered steroids given in the 2-week period after transplantation was investigated.


RESULTS
There were no statistically significant correlations between the development of AVN and age, sex, absence or presence of AR, type of transplanted kidney, or type of immune suppressor. A significant dose-response relationship was found between development of AVN and the total dose of steroid administered in the first 2 weeks after surgery.


CONCLUSIONS
We found a relationship between AVN development and steroid dose in the early postoperative period, and we also showed a dose-response relationship.
Department of Orthopaedics , Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto.
Masazumi
M
Saito
Keiichiro
K
Ueshima
Mikihiro
M
Fujioka
Masashi
M
Ishida
Tsuyoshi
T
Goto
Yuji
Y
Arai
Kazuya
K
Ikoma
Hiroyoshi
H
Fujiwara
Wakaba
W
Fukushima
Toshikazu
T
Kubo
D061605:Administration, Intravenous; D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D000305:Adrenal Cortex Hormones