Evaluation the risk factors that are associated with osteoporosis in post kidney transplantation in a sample of Iraqi patients

Abstract

Renal transplantation is a principal treatment option for end-stage kidney failure. Bone loss and fracture are serious complication of kidney transplantation, associated with morbidity and mortality. The pathogenesis of post transplantation bone loss is multifactorial and complex. There are changes in the normal bone remodeling system which will lead to more accelerated osteoporotic changes compared to normal individuals. The current work aimed to investigate the incidence of osteoporosis in post kidney transplant patients when compared to the general population. And study the relationship between post kidney transplant immunosuppression therapy and osteoporosis and determine some biochemical changes. Also to evaluate the bone mass and the possible correlation between demographic data and the development of osteoporosis. A case control study, conducted in the Kidney Transplant Center – Medical City Complex during the period (from October 2018 till April 2019), seventy-five kidneys transplant patients were participated in the present study including (23 females &52 males). Apparently healthy seventy-five subjects were selected to participate as a normal group for comparison (control) including (35 females and 40 males). All participants were examined for their bone density using DEXA scan (T – score) and those with cut– point ≤- 2.5 were diagnosed as having osteoporosis (lumbar and hip bones were examined). The prevalence of osteoporosis and osteopenia was significantly higher in transplant patients compared to control for lumbar and hip bone (for lumbar bones: 33.3% vs. 2.7% for hip bones: 60% vs. 14.7%). T- score was significantly lower in the transplant patients compared to control for both lumber (-1.9±0.8 vs. - 1.1±0.7) and hip bones (-2.3±0.9 vs. -1.3±0.8).In logistic regression analysis; only gender and BMI were the predictors of osteoporosis for lumbar bone, while; the BMI and serum calcium were the predictors of osteoporosis for hip bones. In conclusion, Osteoporosis in post-renal transplant patients is high when compared to general population, only corticosteroids significantly increase risk of osteoporosis, biochemical marker serum level in post kidney transplant patients are significantly different when compared with the general population but did not increase risk of osteoporosis and Body mass index is a risk factor for both lumbar and hip bones osteoporosis,while gender and serum calcium are risk factors for osteoporosis in lumbar and hip;respectively.