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Clinical predictors of incipient vertebral fractures and bone mineral density in kidney transplant patients
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  • Dilek Gogas Yavuz,
  • Kadriye Aydin,
  • tugce apaydin,
  • Arzu Velioglu,
  • Meral Mert,
  • zafer pekkolay,
  • Ergun Parmaksiz,
  • Meral Mese,
  • Ayse Esen Pazir,
  • Emre Aydın,
  • Onur Bugdayci,
  • Serhan Tuglular
Dilek Gogas Yavuz
Marmara Universitesi Tip Fakultesi
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Kadriye Aydin
Istanbul Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi
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tugce apaydin
Marmara Universitesi Tip Fakultesi
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Arzu Velioglu
Marmara University School of Medicine
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Meral Mert
İstanbul Bakırköy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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zafer pekkolay
Dicle University Medical Faculty
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Ergun Parmaksiz
Istanbul Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi
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Meral Mese
Istanbul Dr Lufti Kirdar Kartal Egitim ve Arastirma Hastanesi
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Ayse Esen Pazir
İstanbul Bakırköy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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Emre Aydın
Dicle University Medical Faculty
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Onur Bugdayci
Marmara Universitesi Tip Fakultesi
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Serhan Tuglular
Marmara University School of Medicine
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Abstract

Purpose: Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients. Methods: Two hundred sixty-four patients (F/M:124/140, 45.3±13 years) who had undergone kidney transplantation between 2008 and 2018 and who were followed up at least one year in third care centers were included in this multicenter retrospective study. Bone mineral densitometry was performed using dual-energy X-ray absorptiometry. Vertebral fractures were assessed semi-quantitatively using conventional thoracolumbar lateral radiography in 202 of the patients. Results: Vertebral fractures were observed in 56.4% (n=114) of the study group. Severe vertebral fractures were observed in 30.7% (n=62) of the patients in vertebral X-ray evaluation. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). BMD levels were in the normal range in 40.3% (n=46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n=23) and the osteopenic range in 40.3% (n=46). Serum calcium, parathormone vitamin, and creatinine levels were similar between the patients with and without vertebral fractures. Femoral neck BMD was negatively correlated with age (r: −0.21, p<0.001) and positively correlated with body mass index (r:0.29, p<0.001). Vertebral fractures were associated with age, duration of hemodialysis, BMI, femoral neck Z score (R2: 37.8%, p=0.027). Conclusion: BMD was in the normal or osteopenic range in 79.8% in our cohort of renal transplant patients with incipient vertebral fractures. As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.