Endocrine Abstracts

Corticosteroid-induced osteonecrosis is seen in 3–4% of patients undergoing kidney transplantation (KT), especially at the head of the femur. The use of corticosteroids for any reason is responsible for approximately 41% of total hip arthroplasty performed due to osteonecrosis. In this study, we investigated factors affecting osteonecrosis development after KT

Methods: Among 205 recipients who underwent KT, 32 (15.6%) had symptomatic femoral head osteonecrosis (FHO group). Fifty patients who were similar in terms of age, sex, and posttransplant follow – up period constituted the non-FHO group.

Results: The gender, age and pre-transplant BMI of both groups were similar. In patients who developed FHO, the onset of symptom was median 6 months (range: 1–40). In patients who developed bilateral FHO, the mean duration of symptomatic change in the other hip was 2.1 months (range: 0–6). The median value of the patients’ diagnosis time was 9 months (range: 1–40). The serum creatinine, calcium, phosphorus, ALP and PTH values at 1st, 6th and 12th after KT in both groups did not differ. There was no significant difference in hip and lumbar DEXA values between the groups in terms of osteonecrosis development. Three patients (9.4%) in the FHO group and seven patients (14%) in the non-FHO group had steroid treatment before KT. Cumulative steroid doses taken after KT the FHO and non-FHO groups were 6366 mg (range: 3230–10947) and 5664 mg (range: 3717–13887) at 12th month (P=0.068). A total of 17 hips total hip prosthesis were performed in 11 patients (six female, five male, mean age 45.2) who developed FHO.

Conclusion: We did not find any association between post-transplantation FBO development, lumbar and femoral bone density measurements, and steroid doses.