신장이식 후 골밀도에 영향을 미치는 인자에 대한 연구
Risk factors that affect bone mineral density after kidney transplantation
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Osteoporosis is a common complication, following kidney transplantation, which profoundly contributes to morbidity. Since bone loss can lead to fracture, it is an important factor that affects quality of life after kidney transplantation. Using the pre-transplant bone mineral density (BMD) data, post-transplant change in the BMD of recipients was retrospectively evaluated. Risk factors that affect bone mineral density after kidney transplantation are classified into three categories; patient-related factors, surgical methods and lab values-related factors, and pharmacotherapy-related factors. Patients enrolled in this study include patients aged over 18 years old, who received kidney transplantation at Seoul National University Hospital from January, 2000 to December, 2008. Bone mineral density is expressed as T-score in DEXA (Dual Energy X-ray Absorptiometry) test, and a lower T-score means lower bone mineral density. By selecting the lowest T-score in lumbar and femur, this study compared bone mineral density before and after kidney transplantation. A total of 86 patients participated in this study, and average difference of T-score was 0.12 in lumbar and -0.08 in femur before and after transplantation. There were 37 patients who experi-enced bone loss in lumbar, and 43 patients experienced bone loss in femur. In this study, it was found that patients who took vitamin D supplements to prevent bone loss experienced less bone loss in lumbar, compared to patients who did not take any medication. Also, patients who took steroid dose over 2.5mg/day experienced greater bone loss in the femur. It can be concluded that patients who take high dose of steroid should closely monitor bone health to prevent bone loss. Aggressive use of vitamin D supplement could be an effective way to prevent bone loss. Further studies will be necessary to find the role of pharmacists in order to prevent bone loss in patients with kidney transplantation.
Abstract
Osteoporosis is a common complication, following kidney transplantation, which profoundly contributes to morbidity. Since bone loss can lead to fracture, it is an important factor that affects quality of life after kidney transplantation. Using the pre-transplant bone mineral density (BMD) data, post-transplant change in the BMD of recipients was retrospectively evaluated. Risk factors that affect bone mineral density after kidney transplantation are classified into three categories; patient-related factors, surgical methods and lab values-related factors, and pharmacotherapy-related factors. Patients enrolled in this study include patients aged over 18 years old, who received kidney transplantation at Seoul National University Hospital from January, 2000 to December, 2008. Bone mineral density is expressed as T-score in DEXA (Dual Energy X-ray Absorptiometry) test, and a lower T-score means lower bone mineral density. By selecting the lowest T-score in lumbar and femur, this study compared bone mineral density before and after kidney transplantation. A total of 86 patients participated in this study, and average difference of T-score was 0.12 in lumbar and -0.08 in femur before and after transplantation. There were 37 patients who experi-enced bone loss in lumbar, and 43 patients experienced bone loss in femur. In this study, it was found that patients who took vitamin D supplements to prevent bone loss experienced less bone loss in lumbar, compared to patients who did not take any medication. Also, patients who took steroid dose over 2.5mg/day experienced greater bone loss in the femur. It can be concluded that patients who take high dose of steroid should closely monitor bone health to prevent bone loss. Aggressive use of vitamin D supplement could be an effective way to prevent bone loss. Further studies will be necessary to find the role of pharmacists in order to prevent bone loss in patients with kidney transplantation.
참고문헌 (15)
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