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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| Format: | Article |
| Language: | English |
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Galenos Publishing House
2025-06-01
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| Series: | Ankara Üniversitesi Tıp Fakültesi Mecmuas |
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| 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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| author | Ömer Faruk Akçay Asil Demirezen Veysel Baran Tomar Ozant Helvacı Galip Güz |
| author_facet | Ömer Faruk Akçay Asil Demirezen Veysel Baran Tomar Ozant Helvacı Galip Güz |
| author_sort | Ömer Faruk Akçay |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-fecb9c807b8f440c9e147dc449345b51 |
| institution | Matheson Library |
| issn | 1307-5608 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Galenos Publishing House |
| record_format | Article |
| series | Ankara Üniversitesi Tıp Fakültesi Mecmuas |
| spelling | doaj-art-fecb9c807b8f440c9e147dc449345b512025-07-17T13:32:35ZengGalenos Publishing HouseAnkara Üniversitesi Tıp Fakültesi Mecmuas1307-56082025-06-0178211311910.4274/atfm.galenos.2025.13281Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center ExperienceÖmer Faruk Akçay0https://orcid.org/0000-0001-6587-4938Asil Demirezen1https://orcid.org/0009-0004-4449-8266Veysel Baran Tomar2https://orcid.org/0000-0003-2123-5207Ozant Helvacı3https://orcid.org/0000-0002-1382-2439Galip Güz4https://orcid.org/0000-0002-9146-2133Gazi University Faculty of Medicine Department of Nephrology, Ankara, TürkiyeGazi University Faculty of Medicine Department of Nephrology, Ankara, TürkiyeGazi University Faculty of Medicine Department of Nephrology, Ankara, TürkiyeGazi University Faculty of Medicine Department of Nephrology, Ankara, TürkiyeGazi University Faculty of Medicine Department of Nephrology, Ankara, TürkiyeObjectives: 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.https://www.ankaratipfakultesimecmuasi.net/articles/avascular-necrosis-and-risk-factors-in-kidney-transplant-recipients-a-single-center-experience/doi/atfm.galenos.2025.13281avascular necrosisglomerulonephritismineral bone diseaserenal transplantationsteroid therapy |
| spellingShingle | Ömer Faruk Akçay Asil Demirezen Veysel Baran Tomar Ozant Helvacı Galip Güz Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience Ankara Üniversitesi Tıp Fakültesi Mecmuas avascular necrosis glomerulonephritis mineral bone disease renal transplantation steroid therapy |
| title | Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience |
| title_full | Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience |
| title_fullStr | Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience |
| title_full_unstemmed | Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience |
| title_short | Avascular Necrosis and Risk Factors in Kidney Transplant Recipients: A Single-Center Experience |
| title_sort | avascular necrosis and risk factors in kidney transplant recipients a single center experience |
| topic | avascular necrosis glomerulonephritis mineral bone disease renal transplantation steroid therapy |
| url | 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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