Relationship between renal function and bone mineral density in kidney transplant recipients

  • María del Cármen López Ruiz Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén
  • Rafael Fernández Castillo Servicio de Nefrología, Hospital Universitario Virgen de las Nieves, Granada
  • Rafael José Esteban De la Rosa Servicio de Nefrología, Hospital Universitario Virgen de las Nieves, Granada
  • Ana Raquel Ortega Martínez Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén
  • Juan Antonio Bravo Soto Servicio de Nefrología, Hospital Universitario Virgen de las Nieves, Granada
Keywords: kidney function tests, renal function, bone mineral density, bone mass, glomerular filtration rate, diet, postransplant

Abstract

Background and objective: To study the relationship between measures of renal function and bone mineral density (BMD) to determine which measure of renal function by Cockcroft-Gault (CG) and estimated glomerular filtration rate by modification of diet in renal disease (MDRD), is more strongly associated with bone mineral density(BMI). Methods: The sample consisted of 310 patients transplanted, 194 men and 116 women, which underwent measurement of bone mineral density in lumbar spine, femur and radioulnar Rx dual absorptiometry (DXA) and renal function estimation by CG and MDRD methods and measurements of body mass index (BMI). Results: Mean bone mineral density and the CG and MDRD filtered, increase after 6 months the first year of transplantation in patients with normal bone mineral density, decreases in osteopenia and osteoporosis increases. BMI measurements were highly correlated with CG filtering the sixth month of transplantation (r = 0.222 p <0.001) and year (r = 0.258 p <0.001). Conclusions: Cockcroft-Gault (CG) and glomerular filtration rate estimated by the Modification of Diet in Renal Disease (MDRD) showed a high association with bone mineral density, but just the renal function as measured by CG is a predictor significant bone loss and fractures.

References

Moe S, Drüeke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. Definition, evaluation, and classification of renal osteodystrophy: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2006;69(11):1945-53.

Cruz DN, Wysolmerski JJ, Brickel HM, Gundberg CG, Simpson CA, Mitnick MA, et al. Parameters of high bone-turnover predict bone loss in renal transplant patients: a longitudinal study. Transplantation. 2001;72(1):83-8.

Fernández Castillo R, De Alarcon RM, Esteban RJ, Haouari O, Planell E, Perán F, et al. Bone mineral density in patients with renal hyperparathyroidism undergoing surgery: relationship with bone parameters. Med Clin (Barc). 2010;135(4):156-9.

Cabrerizo García JL, Zalba Etayo B, Pérez Calvo JI. Valor pronóstico del filtrado glomerular en el síndrome coronario agudo: ¿índice de Cockcroft o ecuación MDRD? Med Clin (Barc). 2010;134(14):624-9.

Martin KJ, Olgaard K, Coburn JW, Coen GM, Fukagawa M, Langman C, et al. Diagnosis, assessment, and treatment of bone turnover abnormalities in renal osteodystrophy. Am J Kidney Dis. 2004;43(3):558-65.

Lenchik L, Kiebzak GM, Blunt BA; International Society for Clinical Densitometry Position Development Panel and Scientific Advisory Committee. What is the role of serial bone mineral density measurements in patient management? J Clin Densitom. 2002;5 Suppl:S29-38,

Kanis JA, Glüer CC. An update on the diagnosis and assessment of osteoporosis with densitometry. Committee of Scientific Advisors, International Osteoporosis Foundation. Osteoporos Int. 2000;11(3):192-202.

Ramsey-Goldman R, Dunn JE, Dunlop DD, Stuart FP, Abecassis MM, Kaufman DB, et al. Increased risk of fracture in patients receiving solid organ transplants. J Bone Miner Res. 1999;14(3):456-63.

O'Shaughnessy EA, Dahl DC, Smith CL, Kasiske BL. Risk factors for fractures in kidney transplantation. Transplantation. 2002;74(3):362-6.

Torres A, Lorenzo V, Salido E. Calcium metabolism and skeletal problems after transplantation. J Am Soc Nephrol. 2002;13(2):551-8.

Cohen A, Shane E. Osteoporosis after solid organ and bone marrow transplantation. Osteoporos Int. 2003;14(8):617-30.

Sprague SM, Josephson MA. Bone disease after kidney transplantation. Semin Nephrol. 2004;24(1):82-90.

Julian BA, Laskow DA, Dubovsky J, Dubovsky EV, Curtis JJ, Quarles LD. Rapid loss of vertebral mineral density after renal transplantation. N Engl J Med. 1991;325(8):544-50.

Torregrosa JV, Campistol JM, Montesinos M, Pons F, Martinez de Osaba MJ. Evolution of bone mineral density after renal transplantation: related factors. Nephrol Dial Transplant. 1995;10(Suppl 6):111-3.

Lamb EJ, Webb MC, O'Riordan SE. Using the modification of diet in renal disease (MDRD) and Cockcroft and Gault equations to estimate glomerular filtration rate (GFR) in older people. Age Ageing. 2007;36(6):689-92.

Stevens LA, Coresh J, Feldman HI, Greene T, Lash JP, Nelson RG, et al. Evaluation of the modification of diet in renal disease study equation in a large diverse population. J Am Soc Nephrol. 2007;18(10):2749-57.

Serra AL, Schwarz AA, Wick FH, Marti HP, Wüthrich RP. Successful treatment of hypercalcemia with cinacalcet in renal transplant recipients with persistent hyperparathyroidism. Nephrol Dial Transplant. 2005;20(7):1315-9.

Castillo RF, de la Rosa RJ. Relation between body mass index and bone mineral density among haemodialysis patients with chronic kidney disease. J Ren Care. 2009;35(Suppl 1):57-64.

Published
2017-10-31
How to Cite
1.
López Ruiz M del C, Fernández Castillo R, De la Rosa RJE, Ortega Martínez AR, Bravo Soto JA. Relationship between renal function and bone mineral density in kidney transplant recipients. Rev Nefrol Dial Traspl. [Internet]. 2017Oct.31 [cited 2024Dec.23];32(1):41-6. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/193
Issue
Vol. 32 No. 1 (2012): Ene.-Mar.
Section
Original Article