Bone mineral density in kidney transplant recipients and patients on hemodialysis. A comparison with healthy individuals

We measured bone mineral density [BMD] before and after transplantation to determine the frequency and severity of preoperative and postoperative osteoporosis and compare them with the BMD in healthy individuals. We determined the BMD at the lumbar spine and femoral levels in 22 men and 18 women who were on long-term dialysis in Yazd, Iran, and a group of kidney transplant recipients including 43 men and 18 women. They were compared with each other and healthy individuals studied in a recent study in Iran. Factors potentially associated with alterations of the BMD were studied in each group. The frequency of osteoporosis in the vertebrae and femoral neck was higher in the kidney transplant recipients than the healthy population [21.3% versus 4.9%; P = .001; odds ratio, 5 and 9.8% versus 2.4%; P = .02; odds ratio, 5.4, respectively] but not significantly different from those in the patients on dialysis [17.9% and 17.5%, respectively]. In transplantation group, multivariate analysis showed that there was a significant negative correlation between the lumbar BMD and the cumulative prednisolone dose [r = -0.36, P = .003]. No correlation was found between BMD of lumbar or femoral neck and the body mass index, age, and cumulative cyclosporine level. Osteoporosis is more frequent in patients on dialysis and kidney transplant recipient than in general population. However, there is no difference in osteoporosis frequency between transplanted patients and those on dialysis. In the lumbar spine, a higher cumulative prednisolone dose results in decreased BMD among kidney transplant recipients