Avascular osteonecrosis in kidney transplant recipients: Risk factors in a recent cohort study and evaluation of the role of secondary hyperparathyroidism

PloS One
Renaud FeltenRose-Marie Javier

Abstract

Avascular osteonecrosis (AVN) is a bone complication that indicates poor functional prognosis. Modern immunosuppressive and steroid-sparing drugs have significantly lowered the occurrence of AVN after kidney transplantation (KT). However, recent data on its incidence rates and risk factors are lacking. Using a large, recent cohort, we sought to investigate AVN incidence and risk factors, with a special focus on mineral and bone disorders. We conducted a cohort study in 805 patients who underwent KT between 2004 and 2014. AVN was identified in 32 patients (4%): before KT in 15 (1.8%) and after KT in 18 (2.2%) cases, including one patient with both. In the group with post-KT AVN, the median time intervals from KT to 1) first symptoms and 2) AVN diagnosis were 12 months [1-99] and 20 months [4-100], respectively. Being overweight/obese, having pre-transplant diabetes or hyperparathyroidism at transplantation, developing acute rejection, and receiving higher cumulative corticosteroid doses were associated with AVN occurrence. Multivariate analysis revealed that BMI ≥ 26 kg/m2 and higher cumulative corticosteroid doses were predictive of AVN. In conclusion, overweight/obesity is a strong risk factor for AVN. Despite a low maintenanc...Continue Reading

References

May 28, 1992·The New England Journal of Medicine·H J Mankin
Dec 1, 1988·Acta Orthopaedica Scandinavica·G S LaustenK Olgaard
Nov 1, 1994·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·J A Kanis
Dec 20, 2000·Transplantation Proceedings·S TangK N Lai
May 12, 2001·Clinical Orthopaedics and Related Research·J W Pritchett
May 19, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Khalid KhwajaArthur J Matas
Sep 14, 2006·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Yakup EkmekciBulent Erbay
May 26, 2007·Transplantation Proceedings·H HedriA Kheder
May 29, 2007·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Tetsurou HirataToshikazu Kubo
Dec 21, 2007·The New England Journal of Medicine·Henrik EkbergUNKNOWN ELITE-Symphony Study
Apr 11, 2009·The Orthopedic Clinics of North America·Muhammad AjmalEdward Y Cheng
Apr 11, 2009·Rheumatology International·Alia Mohamed AtallahMohamed A Ghoneim
May 11, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Kavitha Potluri, Susan Hou
Jan 25, 2011·The Journal of Arthroplasty·Sanjay Agarwala, Satyajit B Shah
Sep 17, 2013·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·P PerrinB Moulin
Sep 1, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Stuart M SpragueSharon M Moe
Sep 16, 2015·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·H-F YuanZ-Q Yan
Sep 24, 2015·World Journal of Orthopedics·Joaquin Moya-AngelerJoseph M Lane
Jun 6, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Thomas SchachtnerPetra Reinke

❮ Previous
Next ❯

Citations

Dec 5, 2020·Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation·Hasan H YeterUlver Derici
Jun 19, 2021·Seminars in Nephrology·Ambreen AzharMiklos Z Molnar

❮ Previous
Next ❯

Methods Mentioned

BETA
X-ray
total hip arthroplasty

Software Mentioned

SAS JMP

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.