P1733MINERAL BONE DISEASE (MBD) IS THE POST KIDNEY TRANSPLANTATION POPULATION
| Autor: | Eva Ruane, Aisling O'Riordan, John Holian, Alan Watson, Louise Ryan |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Nephrology Dialysis Transplantation. 35 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfaa142.p1733 |
| Popis: | Background and Aims Patients with ESRD have a 4-fold higher risk of fracture compared to the general population. (1) Transplant bone disease is a combination of mineral bone disease sustained pre transplantation and damage incurred post transplantation, risk factors for which include immunosuppression and immobility in the early post transplantation period. Given the high morbidity, mortality and financial burden associated with fractures, the management and prevent of osteoporosis is fundamental. (2) We aimed to compare the management of MBD in our patient cohort to international nephrology and rheumatology guidelines. (1, 3) Method A retrospective review of all patients post kidney transplantation attending our department was carried out. Information pertaining to patient demographics, renal history, osteoporosis investigation and management was collected. The results were analysed with Microsoft Excel. Results 154 patient records (92 male, 62 female) were reviewed. Mean age was 52 years (range 19-80). Mean eGFR was 54ml/min (range 9-90). 82% of patients were taking corticosteroids, the mean dose was 5mg. 9% were taking corticosteroids pre-transplantation. 11 patients (7%) had a history of parathyroidectomy. 19% of patients had a history of a fracture. 26% of patients had a DEXA scan performed which demonstrated 50% had osteopenia and 29% had osteoporosis. The mean fracture risk assessment tool (FRAX) score (risk of having an osteoporosis-related fracture in the next 10 years) for a major osteoporotic fracture was 10.2% (range 2.1-34%) and for a hip fracture was 3.1% (range 0.2-18). Based on these scores 19% and 26% of patients respectively met the criteria for treatment. Overall, 58% of patients were on treatment for either osteoporosis prevention or management or for mineral bone disease. 74% of patients with osteopenia were on treatment (32% calcium supplementation, 5% alfacalcidol, and 63% cholecalciferol). 82% of patients with osteoporosis were on treatment (45% cinacalcet, 36% cholecalciferol, 18% bisphosphonate and 9% denosumab). 27% of patients with osteoporosis were managed in keeping the guidelines. Conclusion Our cohort have significant risk factors for osteoporosis including maintenance corticosteroid treatment and previous fractures. There is a high prevalence of osteoporosis in our cohort compared to that reported internationally (4) and they had a high predicted rate of future fractures. Increased screening with targeted treatment is required to reduce the risk of fractures in our post renal transplant patients. |
| Databáze: | OpenAIRE |
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