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Bone Mineral Density in Relation to Chronic Kidney Disease After Heart Transplantation: A Retrospective Single-center Study at Skåne University Hospital in Lund 1988-2016

Löfdahl E1,2Haggård C1,2Rådegran G1,2.

Transplant Direct. 2020 Feb 24;6(3):e537. doi: 10.1097/TXD.0000000000000981. eCollection 2020 Mar.

Abstract

BACKGROUND:

Our aim was to investigate the bone mineral density (BMD) evolution and incidence of osteoporosis in relation to chronic kidney disease (CKD) up to 10 years after heart transplantation (HT).

METHODS:

A retrospective analysis was performed on 159 HT patients at Skåne University Hospital in Lund 1988-2016.

RESULTS:

The median follow-up time was 6.1 years (interquartile range = 7.5 y). HT patients with CKD stage <3 or normal kidney function before HT exhibited a greater mean BMD loss in the lumbar spine, compared to patients with CKD stage ≥3 before HT, at the first (-6.6% versus -2.5%, P = 0.029), second (-3.7% versus 2.1%, P = 0.018), and third (-2.0% versus 4.1%, P = 0.047) postoperative years, respectively. All included HT patients exhibited a BMD loss in the femoral neck at the first postoperative year (-8.8% [-10.3 to -7.3] in patients with CKD stage <3 or normal kidney function and -9.3% [-13.2 to -5.5] in patients with CKD stage ≥3 before HT), which was not fully reversed up to 10 years after HT. In adjusted models, CKD stage <3 before HT did not predict osteopenia and osteoporosis in the lumbar spine or femoral neck.

CONCLUSIONS:

CKD before HT did not predict BMD loss or osteoporosis development after HT. The study is, however, limited by a lack of data on fractures, and further studies on the relationship between CKD and postoperative bone strength are encouraged.