Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function

Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function

Autor Braga Júnior, J.w.r. Autor UNIFESP Google Scholar
Neves, R.m.s. Autor UNIFESP Google Scholar
Pinheiro, Marcelo de Medeiros Autor UNIFESP Google Scholar
Frisoli Júnior, A. Autor UNIFESP Google Scholar
Castro, C.h.m. Autor UNIFESP Google Scholar
Szejnfeld, Vera Lucia Autor UNIFESP Google Scholar
Carvalho, A.b. Autor UNIFESP Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo We evaluated the prevalence of low bone mineral density (BMD) and osteoporotic fractures in kidney transplantation (KT) patients and determined risk factors associated with osteoporotic fractures. The study was conducted on 191 patients (94 men and 97 women) with first KT for 3 years or more presenting stable and preserved renal function (serum creatinine levels lower than 2.5 mg/dl). KT patients were on immunosuppressive therapy and the cumulative doses of these drugs were also evaluated. BMD was determined by dual-energy X-ray absorptiometry at multiple sites (spine, femur and total body). Quantitative ultrasound of the calcaneus (broadband ultrasound attenuation, speed of sound, and stiffness index, SI) was also performed. Twenty-four percent (46) of all patients had either vertebral (29/46) or appendicular (17/46) fractures. We found osteoporosis and osteopenia in 8.5-13.4 and 30.9-35.1% of KT patients, respectively. Women had more fractures than men. In women, prevalent fractures were associated with diabetes mellitus [OR = 11.5, 95% CI (2.4-55.7)], time since menopause [OR = 3.7, 95% CI (1.2-11.9)], femoral neck BMD [OR = 1.99, 95% CI (1.4-2.8)], cumulative dose of steroids [OR = 1.1, 95% CI (1.02-1.12)] and low SI [OR = 1.1, 95% CI (1.0-1.2)]. In men, fractures were associated with lower lumbar spine BMD [OR = 1.75, 95% CI (1.1-2.7)], lower SI [OR = 1.1, 95% CI (1.03-1.13)], duration of dialysis [OR = 1.3, 95% CI (1.13-2.7)], and lower body mass index [OR = 1.24, 95% CI (1.1-1.4). Our results demonstrate high prevalence of low BMD and osteoporotic fractures in patients receiving a successful kidney transplant and indicate the need for specific intervention to prevent osteoporosis in this population.
Palavra-chave Kidney transplantation
Bone density
Quantitative ultrasound
Osteoporosis
Fracture
Idioma Inglês
Data de publicação 2006-01-01
Publicado em Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 39, n. 1, p. 137-147, 2006.
ISSN 0100-879X (Sherpa/Romeo, fator de impacto)
Publicador Associação Brasileira de Divulgação Científica
Extensão 137-147
Fonte http://dx.doi.org/10.1590/S0100-879X2006000100016
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000235089500016
SciELO S0100-879X2006000100016 (estatísticas na SciELO)
Endereço permanente http://repositorio.unifesp.br/handle/11600/2845

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