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RENAL TRANSPLANTASYON SONRASINDA OSTEONEKROZ GELÎŞÎMÎNÎ ETKİLEYEN RÎSK FAKTÖRLERİ

RISK FACTORS INFLUENCING THE DEVELOPMENT OF OSTEONECROSIS AFTER RENAL TRANSPLANTATION

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Purpose: This study was performed to determine risk factors influencing the development of osteonecrosis after renal transplantation. Methods: We retrospectively evaluated osteonecrosis in 308 kidney graft recipients (240 living and 68 cadaveric) who were transplanted and followed-up in our transplant unit between 1986-2000. Kidney recipients transplanted after each of the 29 recipients with osteonecrosis (the mean age: 38.8+10.7; female/male ratio: 9/20) were used as controls (the mean age: 30.8+8.6; female/male ratio: 10/19). Both groups were matched to age, gender, duration of chronic renal failure, cumulative time on dialysis, pretransplant steroid therapy, hyperparathyroidism, renal osteodystrophy, osteoporosis, donor source, immunosuppressive therapy, cumulative steroid dose, creatinine clearance and the findings of serum biochemistry. Mann-Whitney U test and Student's t test were used for stastical analysis. Results: The patients with osteonecrosis were significantly older than controls (p=0.003). Pretransplant renal osteodystrophy was determined in six patients in osteonecrosis group and in one patient in control group (p=0.04). Seven patients had pretransplant osteoporosis in osteonecrosis group and none of the patients in control group(p=0.004). Mean serum triglyceride was measured as 184+103 mg/dl in osteonecrosis group and as 138+53 mg/dl in control group (p=0.03). Mean serum albumin was found as 4.2+0.5 g/dl in osteonecrosis group and as 4.5+0.45 g/dl in control group (p=0.01). The other factors were not different between the two groups. Conclusion: Advanced age, pretransplant renal osteodystrophy and osteoporosis, elevated triglyceride and lower albumin levels 'were found to be risk factors for osteonecrosis in our study.
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Abstract (Original Language): 
Amaç: Renal transplantasyon sonrasında osteonekmz gelişimini etkileyen risk faktörlerinin belirlenmesi. Yöntem: 1986-2000 yılları arasında transplantasyon uygulanan 308 hasta (240 canlı, 68 kadaverik) osteonekmz, gelişimi yönünden retrospektif olarak değerlendirildi. Osteonekroz saptanan 29 hastanın (ortalama yaş 38.8+10.7; kadın: erkek oranı 9:20) herbirinden protokol sırasına göre bir sonraki hastanın alınmasıyla 29 hastayı kapsayan kontrol grubu (ortalama yaş 30.8+8.6; kadın.erkek oranı 10:19) oluşturuldu. Hasta ve kontrol grubu yaş, cinsiyet, kronik böbrek yetersizliği ve diyaliz süresi, pre-transplant steroid kullanımı, hiperparatiroidi, renal osteodistrofı (ROD) ve osteoporoz (OP) varlığı, donör kaynağı, immunosupresif tedavi, kümülatif steroid dozu, kreatinin klirensi ve kan biyokimyası yönünden Mann- Whitney U testi ve Student' s t testi kullanılarak karşılaştırıldı. Bulgular ve sonuç: Her iki grup arasında yaş ortalamaları bakımından anlamlı farklılık bulundu (p=0.003). Osteonekroz grubunda pre-transplant dönemde altı hastada ROD ve yedi hastada OP vardı. Kontrol grubunda bir hastada ROD saptanırken OP hiç saptanmadı (p=0.04 ve p=0.004). Osteonekroz grubunda ortalama trigliserid düzeyi 184+103 mg/dl iken, kontrol grubunda 138+53 mg/dl saptandı (p=0.03). Ortalama serum albümini osteonekroz grubunda 4.2+0.5 gr/dl, kontrol grubunda 4.5+0.45 gr/dl bulundu (p=0.01). Diğer faktörler yönünden ise iki grup arasında anlamlı farklılık bulunmadı. İleri yaş, pre-transplant dönemde ROD ve OP'un varlığı, göreceli olarak yüksek serum trigliserid düzeyi ve düşük serum albümin düzeylerinin osteonekroz gelişimine katkısının olduğu bulundu.
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  • 4
208-212
  • Turkish

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