Avascuar Necrosis of Bone after Kidney Transplantation

Kim, Jung Man; Kim, Yong Sik; Han, Chang Whan; Chu, In Tak; Lim, Kwahn Sue; Bang, Byung Kee; Kim, Yong Soo; Koh, Yong Bok

Abstract

As transplantation for end-stage renal disease has become more common, avascular necrosis has become a major cause of disability after a successful transplantation. We studied the relationship between development of avascular necrosis of bone and the administration and dosage of steroid, cholesterol level and triglyceride level after transplantation in 909 patients who received kidney transplantation from March 1969 until August 1994 at Catholic University, Medical College. These patients were compared against 60 patients who received kidney transplantation and steroid therapy without developing osteonecrosis. Osteonecrosis was observed in 62 of the patients (6.8 per cent) from 3 to 37 months (mean 10) after the transplant operation. The average age was thirty-eight years (range, twenty to sixty-three years). A single bone was involved in 28 patients, while in the rest of the patients there were between two and four different sites. Altogether 109 bones were affected, 102 of them being weight-bearing. The most common sites were the femoral heads, with 32 patients having bilateral involvement. There was no association between the cumulative dosage of prednisone and the development of avascular necrosis. Although the post renal transplant cholesterol and triglyceride level were significantly elevated compared to the pre-renal transplant state, there were no significantly difference between the avascular group and control group.