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Böbrek Nakli Olmuş Hastalarda Osteoporoz Risk Faktörleri

Risk Factors for Osteoporosis in Renal Transplant Recipients

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DOI: 
DOI 10.5262/tndt.2012.1003.12
Abstract (2. Language): 
OBJECTIVE: The aim of our study was to determine the frequency and risk factors of osteoporosis in patients who had undergone renal transplantation in our clinic and had a functional graft. MATERIAL and METHODS: This study included 92 patients who had undergone renal transplantation between 1997 and 2010 and whose bone mineral density was measured after transplantation. RESULTS: Our study included 92 patients. 57 patients (62%) were male and 35 (38%) were female. The mean age of the patients was 36 years (range: 19-62 years). According to the bone mineral density in the femur and/or lumbar vertebrae, 39 (42.4%) patients were normal, 39 (42.4%) had osteopenia and 14 (15.2%) had osteoporosis. There was no statistical relationship between the patients’ age, gender, body mass index, history of parathyroidectomy, total steroid and immunosuppressive drug dose, creatininecalcium- phosphorus-alkaline phosphatase level at the time of the bone mineral density measurement and bone mineral density (p>0,05). CONCLUSION: We did not fi nd any relationship between the above risk factors and bone mineral density. These fi ndings show that bone mineral density is not a good parameter in the follow-up of bone disease after renal transplantation.
Abstract (Original Language): 
AMAÇ: Çalışmamızın amacı, böbrek nakli yaptığımız işlevsel grefti olan hastalarda osteoporoz sıklığını ve risk etmenlerini belirlemektir. GEREÇ ve YÖNTEMLER: 1997-2010 yılları arasında böbrek nakli yapılan, nakil sonrası kemik mineral yoğunluğu (KMY) ölçümü olan 92 hasta ile çalışmamız yapıldı. BULGULAR: 92 hastamızın 57’si (%62) erkek, 35’i (%38) kadın idi. Hastaların yaş ortalaması 36 yıldı (19-62 yıl). Femur ve/veya lomber vertebra KMY sonuçlarına göre; 39 (%42,4) hasta normal, 39 (%42,4) hastada osteopeni ve 14 (%15,2) hastada osteoporoz vardı. KMY sonuçları ile yaşın, cinsiyetin, vücut kitle indeksinin, paratiroidektomi durumunun, toplam steroid ve bağışıklığı baskılayıcı ilaç dozunun, KMY ölçümü sırasındaki serum kreatinin, kalsiyum, fosfor, alkalen fosfataz düzeylerinin arasında anlamlı ilişki yoktu (p>0,05). SONUÇ: Bizim çalışmamızda, risk faktörlerin hiçbirisi ile KMY arasında anlamlı bir ilişki saptanmadı. Bu bulgular; tek başına KMY ölçümünün böbrek naklinden sonra gelişmesi olası kemik hastalığını izlemede iyi bir gösterge olmadığını göstermektedir. Bu konuda pratik yeni yöntemlere gereksinim vardır.
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REFERENCES

References: 

1. Yakupoğlu YK, Özden E, Koçak B, Dilek M, Akpolat T, Arık N,
Cengiz K, Adıbelli Z, Özkaya O, Durupınar B, Tulek NE, Danacı
M, Ceylan L, Sarıkaya Ş: Bir üniversite hastanesinde üç yıllık
böbrek nakli deneyimi. Turk Neph Dial Transpl 2009; 18:76-81
2. Sezer S, Ozdemir FN, Ibis A, Sayin B, Haberal M: Risk factors
for osteoporosis in young renal transplant recipients. Transplant
Proc 2005; 37: 3116-3118
3. Nouri-Majalan N, Sanadgol H, Rahimian M, Soleimani H: Bone
mineral density in kidney transplant recipients and patients on
hemodialysis: A comparison with healthy individuals. Iran
J Kidney Dis 2008; 2: 154-159
4. Trabulus S, Altiparmak MR, Apaydin S, Serdengecti K, Sariyar
M: Treatment of renal transplant recipients with low bone mineral
density: A randomized prospective trial of alendronate, alfacalcidol
and alendronate combined with alfacalcidol. Transplant Proc 2008;
40: 160-166
5. Pereira S, Pedroso S, Martins L, Santos P, Almeida M, Freitas
C, Dias L, Dores J, Almeida R, Castro Henriques A, Teixeira
M: Bone mineral density after simultaneous kidney-pancreas
transplantation: Four years follow-up of 57 recipients. Transplant
Proc 2010; 42: 555-557
6. Ahmadpoor P, Reisi S, Makhdoomi K, Ghafari A, Sepehrvand
N, Rahimi E: Osteoporosis and related risk factors in renal
transplant recipients. Transplant Proc 2009; 41: 2820-2822
7. Sweet MG, Sweet JM, Jeremiah MP, Galazka SS: Diagnosis and
treatment of osteoporosis. Am Fam Physician 2009; 79: 193-200
8. Unal A, Kocyigit I, Sipahioglu MH, Tokgoz B, Kavuncuoglu
F, Oymak O, Utas C: Loss of bone mineral density in renal
transplantation recipients. Transplant Proc 2010; 42: 3550-3553
9. Cunningham J: Posttransplantation bone disease. Transplantation
2005; 79: 629-634
10. Casez JP, Lippuner K, Horber FF, Montandon A, Jaeger P:
Changes in bone mineral density over 18 months following kidney
transplantation: The respective roles of prednisone and parathyroid
hormone. Nephrol Dial Transplant 2002; 17: 1318-1326
11. Monegal A, Navasa M, Guañabens N, Peris P, Pons F, Martínez de
Osaba MJ, Rimola A, Rodés J, Muñoz-Gómez J: Bone mass and
mineral metabolism in liver transplant patients treated with FK506
or cyclosporine A. Calcif Tissue Int 2001; 68: 83-86
12. Webster AC, Woodroffe RC, Taylor RS, Chapman JR, Craig JC:
Tacrolimus versus cyclosporin as primary immunosuppression for
kidney transplant recipients: Meta-analysis and meta-regression of
randomised trial data. BMJ 2005; 331: 810
13. Burdmann EA, Andoh TF, Yu L, Bennett WM: Cyclosporine
nephrotoxicity. Semin Nephrol 2003; 23: 465-476
14. Gaston RS: Current and evolving immunosuppressive regimens in
kidney transplantation. Am J Kidney Dis 2006; 47: 3-21
15. Halloran PF: Immunosuppressive drugs for kidney transplantation.
N Engl J Med 2004; 351: 2715- 2729
16. Hardinger KL, Koch MJ, Brennan DC: Current and future
immunosuppressive strategies in renal transplantation.
Pharmacotherapy 2004; 24: 1159-1176
17. Julian BA, Quarles LD, Niemann KM: Musculoskeletal
complications after renal transplantation: Pathogenesis and
treatment. Am J Kidney Dis 1992; 19: 99-120
18. Meier-Kriesche HU, Li S, Gruessner RW, Fung JJ, Bustami RT, Barr
ML, Leichtman AB: Immunosuppression: Evolution in practice and
trends, 1994-2004. Am J Transplant 2006; 6: 1111-1131
19. Cundy T, Kanis JA, Heynen G, Morris PJ, Oliver DO: Calcium
metabolism and hyperparathyroidism after renal transplantation. Q
J Med 1983; 52: 67-78
20. D’Alessandro AM, Melzer JS, Pirsch JD, Sollinger HW, Kalayoglu
M, Vernon WB, Belzer FO, Starling JR: Tertiary hyperparathyroidism
after renal transplantation: Operative indications. Surgery 1989;
106: 1049-1055
21. Heaf J, Tvedegaard E, Kanstrup IL, Fogh-Andersen N:
Hyperparathyroidism and long-term bone loss after renal
transplantation. Clin Transplant 2003; 17: 268-274
22. Lindsay R, Nieves J, Formica C, Henneman E, Woelfert L, Shen V,
Dempster D, Cosman F: Randomised controlled study of effect of
parathyroid hormone on vertebral-bone mass and fracture incidence
among postmenopausal women on oestrogen with osteoporosis.
Lancet 1997; 350: 550-555
23. Neer RM, Arnaud CD, Zanchetta JR, Prince R, Gaich GA, Reginster
JY, Hodsman AB, Eriksen EF, Ish-Shalom S, Genant HK, Wang O,
Mitlak BH: Effect of parathyroid hormone (1-34) on fractures and
bone mineral density in postmenopausal women with osteoporosis.
N Engl J Med 2001; 344: 1434-1441
24. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant
Work Group. KDIGO clinical practice guideline for the care of
kidney transplant recipients. Am J Transplant 2009; 9 (Suppl 3):
1-155

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