Post-Renal Transplantation Bone Health in Children Evaluated by Means of Quantitative Ultrasound and Densitometry.
BACKGROUND
Patients with end-stage renal disease develop bone mineral disease, which is not always resolved after a successful renal transplantation; moreover, some of the immunosuppressants used to prevent graft rejection may affect bone health. The aim of this study was to evaluate bone health in post-renal transplantation children with the use of quantitative ultrasound (QUS) and dual-energy X-ray absorptiometry (DXA).


METHODS
A descriptive study was performed in children >3 months after renal transplantation and with stable function of graft. Radial QUS and DXA (lumbar spine and total body less head (TBLH) were performed on the same day.


RESULTS
A total of 35 patients were included. Mean age was 13.9 ± 3.9 years. Ten subjects had total bone density score <2 (28.5%), 4 a lumbar spine (L1-L4) Z-score of <2 (11.4%) as well as TBLH <2, and 6 subjects had a radial QUS Z-score of <2 (17.1%), and only 2 of them had concomitant Z-score <2 with the use of DXA. There was a positive non-significant correlation between TBLH and radial QUS Z-scores (Pearson r = 0.317; P = .016) and a positive significant correlation of DXA lumbar spine and radial QUS Z-scores (Pearson r = 0.452; P = .014).


CONCLUSIONS
Despite a good correlation between TBLH and QUS Z-scores, there are subjects that can be considered normal by QUS and have osteopenia by TBLH DXA and vice versa; this could be due to the different bone areas evaluated.
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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González-Jorge
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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Enciso
Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de México Federico Gómez, México DF, México.
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Reyes
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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Hernández
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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Ortiz
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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Aldana
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México.
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Velásquez-Forero
Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México DF, México.
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Ambrosi
Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México DF, México.
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Clark
Unidad de Investigación en Epidemiología Clínica, Hospital Infantil de México Federico Gómez, México DF, México.
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Méndez
Centro de Adiestramiento en Investigación Clínica, Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social, México DF, México.
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Rivas-Ruiz
Laboratorio de Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, México DF, México; Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, México DF, México. Electronic address: medeiro.mara@gmail.com.
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Medeiros
D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000503:physiopathology; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D007166:Immunosuppressive Agents