Abstract: TH-PO858
Correlates of Bone Mineral Density and Fractures in Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Paudel, Sujay Dutta, Loma Linda University, Loma Linda, California, United States
- Nguyen, Thai, Loma Linda University, Loma Linda, California, United States
- Fung, Enrica, Loma Linda University, Loma Linda, California, United States
Background
Although kidney transplant recipient are known to be at high risk for bone disease, the optimal timing of testing for bone health and risk factors for osteodystrophy remain unclear.
Methods
We conducted a retrospective analysis of 65 patients from the Veterans Affairs at Loma Linda, California who underwent at least one DEXA scan after receipt of kidney transplantation.
Results
The mean age of our cohort was 64.0+/-12.2 and was predominantly male. Most patients received a combination of calcineurin inhibitor, antimetabolite and steroids for immunosuppression. Thirty patients had normal DEXA scans, while 25 patients were osteopenic and 10 were osteoporotic by DEXA; and 11 had documented fracture(s). Many patients received calcium and vitamin D prophylaxis but few received bisphosphonates or calcimimetics post transplant. (Table 1) In a multivariate model, after adjusting for age, dialysis vintage and other characteristics, we found that female gender was correlated with higher risk of fractures. In the same model, there was also a trend towards diabetes and high PTH (>300) predicting higher risk of fractures although this relationship did not reach statistical significance.
Conclusion
Despite the prevalence of bone disease among kidney transplant recipients, we found that a significant portion of such patients may not be receiving optimal therapy. Further studies are needed to establish effective treatments and determine the optimal monitoring frequency of bone parameters.
Table 1: Cohort characteristics
Legend: DDKT: deceased donor kidney transplant; LRKT: living related kidney transplant; LUKT: living unrelated kidney transplant. Values are reported as mean ± SD or N (%), as appropriate.