title: Bone fractures and lumbar mineral density after renal transplantation. A long-term cross-sectional study.
abstract: BACKGROUND
  The purpose of this work was to investigate the association of vertebral and peripheral fractures 10 yr after grafting with bone metabolic markers and body mass density (BMD).
  
  
  METHODS
  One hundred thirty-eight recipients with stable graft function were included in a cross-sectional study. Graft function, biochemical mineral metabolism markers and body mass density (DEXA) were measured. Vertebral fractures were assessed by a semiquantitative analysis of lateral spine X-ray exam.
  
  
  RESULTS
  At the time of the study, intact parathyroid hormone levels were 127.5 ± 78.4 pg/mL and serum calcidiol 20.4 ± 9.3 ng/mL. DEXA showed osteopenia in 47% and osteoporosis in 23% at lumbar spine, 51% and 14% at femoral neck, and 53% and 8% at trochanter. Eighty-five recipients presented vertebral fractures, 69 mild and 16 moderate/severe fractures. In the multivariate analysis, vertebral fractures were associated with older age (p = 0.010), length of follow-up (p = 0.022) and trochanter T-score (p = 0.038). Twenty-three patients presented peripheral fractures and 19 of them also had vertebral fractures. Patients with peripheral fractures were younger, mostly women and had lower BMD.
  
  
  CONCLUSIONS
  Vertebral fractures were associated with lower BMD at trochanter. Most fractures were mild and were several times more frequent than in general population. Their clinical significance needs to be determined.
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Jiménez
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Roberto
authors.initials: R
authors.lastname: Marcén
authors.affiliation: Radiology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Vaamonde
authors.affiliation: Nuclear Medicine, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Caballero
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández-Rodríguez
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Villafruela
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Galeano
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Teruel
authors.affiliation: Department of Nephrology, Ramón y Cajal Hospital, Madrid, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Quereda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015519:Bone Density; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000175:diagnosis / Q000209:etiology*; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000175:diagnosis / Q000209:etiology*; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000209:etiology*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: osteopenia/osteoporosis; peripheral fractures; renal transplantation; secondary persistent hyperparathyroidism; vertebral fractures; vitamin D deficiency