Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience
Objectives: Renal osteodystrophy, osteoporosis, bone fractures, and avascular necrosis (AVN) are prevalent complications observed in the post-transplant period among kidney transplant recipients (KTRs). Despite notable advancements, AVN remains a significant and devastating complication following ki...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Galenos Publishing House
2025-06-01
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| Series: | Ankara Üniversitesi Tıp Fakültesi Mecmuas |
| Subjects: | |
| Online Access: | https://www.ankaratipfakultesimecmuasi.net/articles/avascular-necrosis-and-risk-factors-in-kidney-transplant-recipients-a-single-center-experience/doi/atfm.galenos.2025.13281 |
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| Summary: | Objectives: Renal osteodystrophy, osteoporosis, bone fractures, and avascular necrosis (AVN) are prevalent complications observed in the post-transplant 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 follow-up (n=343). 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%, p<0.001), and more rejection episodes occurred at follow-up (33% vs. 15%, p=0.01). 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, p<0.001).
Conclusion: Our study found GN to be associated with an increased risk of AVN. A higher prevalence of AVN may attributed to long-term pre-transplant 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. |
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| ISSN: | 1307-5608 |