title: DXA variations and fractures after simultaneous pancreas-renal transplantation: results of a long-term follow-up.
abstract: Simultaneous pancreas-kidney transplant (SPKT) has been associated with an increased risk of fracture. We prospectively evaluated the long-term effects of SPKT on bone mineral density (BMD) and fracture risk. During 1998 to 1999, 29 participants were consecutively monitored, and 18 completed the 10-year follow-up. Laboratory blood parameters, lumbar-dorsal radiography, and DEXA were determined at baseline, 1 year, and 10 years. The medical record was reviewed for peripheral fragility fractures. The BMD revealed no changes between baseline and 1 or 10 years after SPKT. Lumbar-dorsal radiography showed 0% asymptomatic vertebral fractures at baseline and after 1 year with 16.7% at 10 years. Vertebral asymptomatic fractures were correlated with acute rejection episodes (P = 0.025). During the first year, no nonvertebral fractures were identified. At the end of the follow-up, 5 nonvertebral fractures in 4 patients were reported. Dorsal and lumbar spine fractures correlated with lumbar spine t score (r = -0.591, P =0.022) and peripheral fractures with femoral neck t score (r = -0.633, P = 0.013). Patients with SPKT did not show long-term significant loss of BMD. The incidence of vertebral fractures was low and related to steroid treatment; the incidence of peripheral fractures was higher and independent of clinical or biochemical parameters.
authors.affiliation: From the Departments of *Nephrology and Renal Transplant, and †Nuclear Medicine, Hospital Clinic, Barcelona, Spain; ‡Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy, and §Department of Radiology, University of Southern California, Los Angeles, CA.
authors.forename: José-Vicente
authors.initials: JV
authors.lastname: Torregrosa
authors.forename: Ana
authors.initials: A
authors.lastname: Sánchez-Escuredo
authors.forename: David
authors.initials: D
authors.lastname: Fuster
authors.forename: Xoana
authors.initials: X
authors.lastname: Barros
authors.forename: Francisco
authors.initials: F
authors.lastname: Campos
authors.forename: África
authors.initials: Á
authors.lastname: Muxí
authors.forename: Pilar
authors.initials: P
authors.lastname: Perlaza
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Marzola
authors.forename: Sotirios
authors.initials: S
authors.lastname: Chondrogiannis
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Colletti
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: María José
authors.initials: MJ
authors.lastname: Ricart
mesh_terms: D000328:Adult; D015519:Bone Density; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011859:Radiography