Department of Endocrinology and Metabolism, Marmara University School of Medicine, Istanbul, Turkey.
Department of Endocrinology and Metabolism, Kartal Lutfi Kirdar Research and Training Hospital, Istanbul, Turkey.
Eur Spine J. 2022 Sep;31(9):2423-2430. doi: 10.1007/s00586-022-07162-6. Epub 2022 Apr 4.
Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients.
Two hundred sixty-four patients (F/M 124/140, 45.3 ± 13 years) who had undergone kidney transplantation in tertiary care centers were included. Vertebral fractures were assessed semiquantitatively using conventional thoracolumbar lateral radiography in 202 of the patients.
Vertebral fractures were observed in 56.4% (n = 114) of the study group. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). Bone mineral density (BMD) levels were in the normal range in 40.3% (n = 46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n = 23) and the osteopenic range in 40.3% (n = 46). Vertebral fractures were associated with age, duration of hemodialysis, BMI, and femoral neck Z score (R 37.8%, p = 0.027).
As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.
肾移植受者易发生代谢性骨病和随之而来的骨折。本研究旨在评估一组肾移植患者中初发椎体骨折、骨量减少、骨质疏松症的发生率以及与初发椎体骨折相关的临床因素。
纳入了在三级医疗中心接受肾移植的 264 名患者（男/女 124/140，45.3±13 岁）。其中 202 名患者接受了常规胸腰椎侧位 X 线片进行半定量评估。
研究组中 56.4%（n=114）观察到椎体骨折。骨质疏松症的发生率为 20.0%（264 名患者中有 53 名），骨量减少为 35.6%（264 名患者中有 94 名）。40.3%（n=46）的椎体骨折患者的骨矿物质密度（BMD）水平在正常范围内。20.1%（n=23）的患者 BMD 水平处于骨质疏松范围，40.3%（n=46）的患者 BMD 水平处于骨量减少范围。椎体骨折与年龄、血液透析时间、BMI 和股骨颈 Z 评分相关（R37.8%，p=0.027）。
由于肾移植受者中可观察到 BMD 水平正常的初发椎体骨折，因此对常规 X 射线筛查椎体骨折可能有助于为肾移植受者代谢性骨病的适当治疗决策提供参考。
