Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2015) 37 GP10.04 | DOI: 10.1530/endoabs.37.GP.10.04

ECE2015 Guided Posters Calcium, Vitamin D and Bone (10 abstracts)

Osteoporosis and osteopenia in patients after kidney and pancreas transplantation

Jana Brunova 1 , Simona Kratochvilova 1 & Josef Bruna 2


1Institute for Clinical and Experimental Medicine, Prague, Czech Republic; 2Medical Faculty Hospital Motol, Prague, Czech Republic.


Background: Organ transplantation (Tx) is the standard treatment for end-stage renal failure in diabetic patients. With an improvement in patient and graft survival, the bone loss and persistent abnormalities in bone metabolism are long-term complications to manage.

Patients and methods: We investigated the prevalence of osteoporosis and osteopenia in 256 diabetic patients (142M, 114F) after the kidney and pancreas Tx for renal failure due to diabetic nephropathy. The bone loss was diagnosed with densitometry (DEXA) using Lunar Prodigy apparatus in years 2010–2014. The characteristics of bone metabolism were regularly examined and we measured on the plain CXR the clavicle bone index, which is the ratio of cortical bone width to total bone width at the midpoint of the shaft.

Results: Osteoporosis of lumbar spine (L spine) and/or hips was diagnosed in 53/256 patients (20%), osteopenia in 135/256 (52%) and 68/256 (28%) of patients had normal bone density. Patients with osteoporosis had affected mainly proximal femurs (hips) in (50/53 (94%) cases and distal forearm in 32/53 (60%). Osteoporosis of L spine was proven in 11/53 patients (21%) and osteopenia in 28/53 (53%) cases. Patients did not differ significantly in age, creatinine, calcium and parathormone (PTH) level. There was a tendency to lower BMD with years after the kidney and pancreas Tx (see Table). The bone index showed good correlation with the bone density measured by DEXA (P<0.01).

PatientsnAge (years)After Tx (years)Creatinine (μmol/l)Ca (mmol/l)PTH (pmol/l)
Osteoporosis5351.78.4147.72.414.6
Osteopenia13552.97.7145.32.416.7
Normal BMD6854.66.8147.32.413.8

Conclusion: Diabetic patients after kidney and pancreas Tx have increased prevalence of osteopenia and osteoporosis (72%). Osteoporosis affects mainly the hips (94%) and distal forearm. Evaluation and managing of bone disease should be an integral part of pre- and after Tx medical care.

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