Bone Mineral Density After Simultaneous Kidney–Pancreas Transplantation: Four Years Follow-up of 57 Recipients
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- 作者：S. Pereira ; S. Pedroso ; L. Martins ; P. Santos ; M. Almeida ; C. Freitas ; L. Dias ; J. Dores ; R. Almeida ; A. Castro Henriques ; M. Teixeira
- 刊名：Transplantation Proceedings
- 出版年：2010
- 出版时间：March 2010
- 年：2010
- 卷：42
- 期：2
- 页码：555-557
- 全文大小：181 K
文摘
Bone disease and an high risk of fractures are major problems in transplantation. Among diabetic patients undergoing simultaneous kidney–pancreas (SKP) transplantation, there are few studies assessing long-term effects on bone mass. The aim of this study was to evaluate bone mineral density (BMD) over 4 years follow-up after SKP transplantation. Fifty-seven patients had 22.8 ± 5.3 years of prior diabetes, 65 % were female, and the overall mean age was 24.3 ± 5.93 years. At the time of transplantation, the lumbar spine and femoral neck T-scores were −1.75 ± 1.05 and −1.95 ± 0.73, respectively; 28 % of subjects had evidence of osteoporosis. One year after transplantation, 77.6 % of patients displayed improved lumbar T-scores to −1.33 ± 0.94 (P = .044) with stable femoral neck T-scores. Bone densitometry enhanced gradually through the 4 years follow-up: lumbar T-score to −1.04 ± 0.67 (P = .004) and femoral neck T-score to −1.69 ± 0.49 (P = .12). At year 4, no osteoporosis cases were detected but 86.7 % of patients did not receive steroids in the immunosuppressive regimen. The graft function remained stable (serum creatinine, 1.2 mg/dL; fasting glucose, 87.7 mg/dL). During the follow-up, BMD improved more significantly at cortical sites. Our study reports a reduced prevalence of fractures (8.7 % ) compared with the literature, which could be related to a steroid-sparing protocol and/or aggressively treatment of osteoporosis.