Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience

Ömer Faruk Akçay; Veysel Baran Tomar; Özant Helvacı; Galıp Güz

Makale detayları

Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience

Yazarlar:

Ömer Faruk Akçay | Veysel Baran Tomar | Özant Helvacı | Galıp Güz

Yayıncı:

Ankara University

Ana Başlıklar:

Nefroloji

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

1/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352116

pISSN:

0365-8104

Anahtar kelimeler:

Özet:

 Objectives: Renal osteodystrophy, osteoporosis, bone fractures, and avascular necrosis AVN are prevalent complications observed in the posttransplant period among kidney transplant recipients KTRs. Despite notable advancements, AVN remains a significant and devastating complication following kidney transplantation KT. Materials and Methods: The study included all patients who underwent KT at our transplantation unit and had at least one year of routine followup n343. Cases of symptomatic AVN were diagnosed by X-radiation, radioisotope bone scan, or magnetic resonance imaging. We evaluated the baseline characteristics, laboratories, and immunosuppressive treatments of KTRs. Results: The frequency of AVN in our KTRs was 7.9 during the follow-up period, with a median diagnosis time of 15.2 10.2-34.9 months. In KTRs with AVN, the leading cause of end-stage renal disease was glomerulonephritis GN 52 vs. 20, p0.001, and more rejection episodes occurred at follow-up 33 vs. 15, p0.01. In univariate analysis, GN odds ratio OR: 4.325, 95 confidence interval CI, 1.936-9.661, cumulative steroid dosage at the post-transplant first year OR: 1.001, 95 CI, 1.000-1.002, and rejection episodes OR: 2.792, 95 CI, 1.185-6.578 detected as possible risk factors for AVN. Upon multivariate analysis, GN was identified as an independent risk factor for the development of AVN OR: 4.373, 95 CI, 1.935-9.880, p0.001. Conclusion: Our study found GN to be associated with an increased risk of AVN. A higher prevalence of AVN may attributed to long-term pretransplant steroid therapy in this group. In KTRs with a history of GN, greater awareness should be paid to cumulative steroid dosages, and early discontinuation of steroids may be considered.

 Objectives: Renal osteodystrophy, osteoporosis, bone fractures, and avascular necrosis AVN are prevalent complications observed in the posttransplant period among kidney transplant recipients KTRs. Despite notable advancements, AVN remains a significant and devastating complication following kidney transplantation KT. Materials and Methods: The study included all patients who underwent KT at our transplantation unit and had at least one year of routine followup n343. Cases of symptomatic AVN were diagnosed by X-radiation, radioisotope bone scan, or magnetic resonance imaging. We evaluated the baseline characteristics, laboratories, and immunosuppressive treatments of KTRs. Results: The frequency of AVN in our KTRs was 7.9 during the follow-up period, with a median diagnosis time of 15.2 10.2-34.9 months. In KTRs with AVN, the leading cause of end-stage renal disease was glomerulonephritis GN 52 vs. 20, p0.001, and more rejection episodes occurred at follow-up 33 vs. 15, p0.01. In univariate analysis, GN odds ratio OR: 4.325, 95 confidence interval CI, 1.936-9.661, cumulative steroid dosage at the post-transplant first year OR: 1.001, 95 CI, 1.000-1.002, and rejection episodes OR: 2.792, 95 CI, 1.185-6.578 detected as possible risk factors for AVN. Upon multivariate analysis, GN was identified as an independent risk factor for the development of AVN OR: 4.373, 95 CI, 1.935-9.880, p0.001. Conclusion: Our study found GN to be associated with an increased risk of AVN. A higher prevalence of AVN may attributed to long-term pretransplant steroid therapy in this group. In KTRs with a history of GN, greater awareness should be paid to cumulative steroid dosages, and early discontinuation of steroids may be considered.

 Objectives: Renal osteodystrophy, osteoporosis, bone fractures, and avascular necrosis AVN are prevalent complications observed in the posttransplant period among kidney transplant recipients KTRs. Despite notable advancements, AVN remains a significant and devastating complication following kidney transplantation KT. Materials and Methods: The study included all patients who underwent KT at our transplantation unit and had at least one year of routine followup n343. Cases of symptomatic AVN were diagnosed by X-radiation, radioisotope bone scan, or magnetic resonance imaging. We evaluated the baseline characteristics, laboratories, and immunosuppressive treatments of KTRs. Results: The frequency of AVN in our KTRs was 7.9 during the follow-up period, with a median diagnosis time of 15.2 10.2-34.9 months. In KTRs with AVN, the leading cause of end-stage renal disease was glomerulonephritis GN 52 vs. 20, p0.001, and more rejection episodes occurred at follow-up 33 vs. 15, p0.01. In univariate analysis, GN odds ratio OR: 4.325, 95 confidence interval CI, 1.936-9.661, cumulative steroid dosage at the post-transplant first year OR: 1.001, 95 CI, 1.000-1.002, and rejection episodes OR: 2.792, 95 CI, 1.185-6.578 detected as possible risk factors for AVN. Upon multivariate analysis, GN was identified as an independent risk factor for the development of AVN OR: 4.373, 95 CI, 1.935-9.880, p0.001. Conclusion: Our study found GN to be associated with an increased risk of AVN. A higher prevalence of AVN may attributed to long-term pretransplant steroid therapy in this group. In KTRs with a history of GN, greater awareness should be paid to cumulative steroid dosages, and early discontinuation of steroids may be considered.

 Amaç: Renal osteodistrofi, osteoporoz, kemik kırıkları ve avasküler nekroz AVN, böbrek nakli alıcılarında BNA transplantasyon sonrası dönemde yaygın komplikasyonlardır. Kaydedilen önemli ilerlemelere rağmen, AVN böbrek nakli BN sonrası hala ciddi ve yıkıcı bir komplikasyon olmaya devam etmektedir. Gereç ve Yöntem: Çalışmaya, transplantasyon ünitemizde BN yapılan ve en az bir yıl düzenli takip edilen tüm hastalar n343 dahil edildi. Semptomatik AVN vakaları röntgen, radyoizotop kemik taraması veya manyetik rezonans görüntüleme ile teşhis edildi. BNAların temel özellikleri, laboratuvar sonuçları ve immünsüpresif tedavileri değerlendirildi. Bulgular: BNAlarda AVN sıklığı 7,9 olup, medyan teşhis süresi 15,2 10,2-34,9 ay olarak belirlendi. AVN gelişen BNAlarda, son dönem böbrek hastalığının en yaygın nedeni glomerulonefrit GN idi 52ye karşı 20, p0,001 ve takip sürecinde daha fazla rejeksiyon epizodu görüldü 33e karşı 15, p0,01. Tek değişkenli analizde GN olasılık oranı OR: 4,325; 95 güven aralığı GA, 1,936-9,661, nakil sonrası ilk yıldaki kümülatif steroid dozu OR: 1,001; 95 GA, 1,000-1,002 ve rejeksiyon epizodları OR: 2,792; 95 GA, 1,185-6,578 AVN için olası risk faktörleri olarak saptandı. Çok değişkenli analizde ise GN, AVN gelişimi için bağımsız bir risk faktörü olarak belirlendi OR: 4,373; 95 GA, 1,935-9,880;.

Makale detayları

Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience

Yazarlar:

Ömer Faruk Akçay | Veysel Baran Tomar | Özant Helvacı | Galıp Güz

Yayıncı:

Ankara University

Ana Başlıklar:

Nefroloji

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

1/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352116

pISSN:

0365-8104

Avascular necrosis

glomerulonephritis

mineral bone disease

renal transplantation

steroid therapyAvascular necrosis

glomerulonephritis

mineral bone disease

renal transplantation

steroid therapy

Sayı

Makale detayları

Yazarlar: Ömer Faruk Akçay | Veysel Baran Tomar | Özant Helvacı | Galıp Güz

Yayıncı: Ankara University

Ana Başlıklar: Nefroloji

Dergi: Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 2, pp.113-119

Belge Tipi: Makale

Yayın Tarihi: 1/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001352116

pISSN: 0365-8104

Sayı

Yazarlar:

Ömer Faruk Akçay | Veysel Baran Tomar | Özant Helvacı | Galıp Güz

Yayıncı:

Ankara University

Ana Başlıklar:

Nefroloji

Dergi:

Ankara Üniversitesi Tıp Fakültesi Mecmuası Vol.78 Issue 2, pp.113-119

Belge Tipi:

Makale

Yayın Tarihi:

1/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001352116

pISSN:

0365-8104