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Assessment of bone mineral density by DEXA inpotential pre transplant patients on maintenance hemodialysis.
Indian J Transplant 2008; 2: 25-31
Conclusions : Post renal transplant, patients gain significant amount of weight, mostly due to accumulation of the fat, especially around the trunk There is overall decrease in bone mineral content, mostly in the spine. Anthropometric measurements for fat assessment are a reasonable substitute for DXA. Leptin levels correlate with body fat content and baseline leptin levels predict subsequent fat gain.
Outcome Of Kidney Transplantation In Secondary Renal Amyloidosis : A Single Centre Experience Rokade M.S, Hegde U N , Gohel K, Gang S, Rajapurkar MM Muljibhai Patel Urological Hospital, Nadiad
Abstrcats: XVIII Conference of ISOT 2007
29
two groups. The number of post transplant infections in the two groups was not statistically significant.
Conclusion : Though renal transplantation has been proven to be a safe option in patients with renal amyloidosis, our study showed a statistically significant lower graft as well as patient survival when compared with non-amyloidotic patients. The lower patient survival may be due to two patients with hepatitis B who died of hepatic failure.
Assessment of bone mineral density by DEXA inpotential pre transplant patients on maintenance hemodialysis. V.V.Sai Naresh+, C.Shobha Rani+, C.V. Harinarayan*, Alok Sachan*, V.Siva Kumar+;
Background :
+ Dept of Nephrology and Hypertension, *Endocrinology and Metabolism, Sri Venkateswara Institute of Medical sciences (SVIMS), Tirupati, A.P. India
Renal transplantation is regarded as the effective renal replacement therapy in patients with renal amyloidosis.
Aim :
Aim : This retrospective study was done to investigate the results of kidney transplantation in patients with secondary renal amyloidosis.
Materials and Methods : We studied 9 patients with systemic amyloidosis who received live related renal transplantation from 1987 to 2007. Graft survival, patient survival, post transplant infections and number of rejections were noted and compared with a control group of nine nonamyloidotic patients.
Results : 8/9 patients were male with a mean age of 30 ± 7.59 years. Amyloidosis was secondary to tuberculosis in seven, bronchiectasis and rheumatoid arthritis in one each. Two patients were seropositive for hepatitis B. The mean follow up was 30 months. One year, five year and ten year actuarial patient survival rates of the amyloidosis versus control groups were 77.7%, 48.61%, 32.4% versus 100%, 100%, 100% respectively (P=0.08, P=0.02*, P=0.006* respectively). 5/9 patients with renal amyloidosis died; while 4/9 lost their grafts. Two patients died with functioning grafts. Both the patients who were seropositive for hepatitis B died of hepatic failure. The other three patients died due to fungal sepsis, acute pulmonary edema and aspiration pneumonitis. The actuarial graft survival of the amyloidosis versus control groups was 66.67%, 66.67%, 66.67% versus 100%, 100%, 87.50% respectively (P=0.04*, P=0.08, P=0.21 respectively).The frequency of acute rejection episodes was not significantly different between members of the
To assess bone mineral density by DEXA and to study the divalention, intact PTH, 25 OH D statuses in potential recipients on maintenance hemodialysis.
Material and Methods : Eighteen patients of ESRD who are on maintenance hemodialysis for more than 3 months were assessed. Serum calcium, phosphate, alkaline phosphatase, intact PTH, 25 OH D levels were estimated along with bone mineral density (DEXA scan).
Results : Male:female ratio was 2:1, the KT/V was more than 1 for all the subjects, Calcium × phosphorus product was < 55 mg2 /dl2 in 16 subjects and > 55mg2 / dl2 in two of them. The intact PTH values were less than 100pg/ml in 5, 100-300pg/dl in 10 and > 300pg/dl in 3. The 25 OH D levels were <30ng/ml in 16 (89%). BMD by DEXA revealed osteoporosis in 50% and osteopenia in 50% subjects.
Conclusion : Majority of patients were 25 OH D deficient. They had abnormal bone mineral density documented as osteopenia/osteoporosis. In most of them the corrected Ca × PO4 product was within normal limits. Intact PTH levels were suggestive of hyperdynamic bone disease in 3, hypodynamic/adynamic bone disease in 5 of them.
Copyright © 2008 by The Indian Society of Organ Transplantation
Conclusions : Post renal transplant, patients gain significant amount of weight, mostly due to accumulation of the fat, especially around the trunk There is overall decrease in bone mineral content, mostly in the spine. Anthropometric measurements for fat assessment are a reasonable substitute for DXA. Leptin levels correlate with body fat content and baseline leptin levels predict subsequent fat gain.
Outcome Of Kidney Transplantation In Secondary Renal Amyloidosis : A Single Centre Experience Rokade M.S, Hegde U N , Gohel K, Gang S, Rajapurkar MM Muljibhai Patel Urological Hospital, Nadiad
Abstrcats: XVIII Conference of ISOT 2007
29
two groups. The number of post transplant infections in the two groups was not statistically significant.
Conclusion : Though renal transplantation has been proven to be a safe option in patients with renal amyloidosis, our study showed a statistically significant lower graft as well as patient survival when compared with non-amyloidotic patients. The lower patient survival may be due to two patients with hepatitis B who died of hepatic failure.
Assessment of bone mineral density by DEXA inpotential pre transplant patients on maintenance hemodialysis. V.V.Sai Naresh+, C.Shobha Rani+, C.V. Harinarayan*, Alok Sachan*, V.Siva Kumar+;
Background :
+ Dept of Nephrology and Hypertension, *Endocrinology and Metabolism, Sri Venkateswara Institute of Medical sciences (SVIMS), Tirupati, A.P. India
Renal transplantation is regarded as the effective renal replacement therapy in patients with renal amyloidosis.
Aim :
Aim : This retrospective study was done to investigate the results of kidney transplantation in patients with secondary renal amyloidosis.
Materials and Methods : We studied 9 patients with systemic amyloidosis who received live related renal transplantation from 1987 to 2007. Graft survival, patient survival, post transplant infections and number of rejections were noted and compared with a control group of nine nonamyloidotic patients.
Results : 8/9 patients were male with a mean age of 30 ± 7.59 years. Amyloidosis was secondary to tuberculosis in seven, bronchiectasis and rheumatoid arthritis in one each. Two patients were seropositive for hepatitis B. The mean follow up was 30 months. One year, five year and ten year actuarial patient survival rates of the amyloidosis versus control groups were 77.7%, 48.61%, 32.4% versus 100%, 100%, 100% respectively (P=0.08, P=0.02*, P=0.006* respectively). 5/9 patients with renal amyloidosis died; while 4/9 lost their grafts. Two patients died with functioning grafts. Both the patients who were seropositive for hepatitis B died of hepatic failure. The other three patients died due to fungal sepsis, acute pulmonary edema and aspiration pneumonitis. The actuarial graft survival of the amyloidosis versus control groups was 66.67%, 66.67%, 66.67% versus 100%, 100%, 87.50% respectively (P=0.04*, P=0.08, P=0.21 respectively).The frequency of acute rejection episodes was not significantly different between members of the
To assess bone mineral density by DEXA and to study the divalention, intact PTH, 25 OH D statuses in potential recipients on maintenance hemodialysis.
Material and Methods : Eighteen patients of ESRD who are on maintenance hemodialysis for more than 3 months were assessed. Serum calcium, phosphate, alkaline phosphatase, intact PTH, 25 OH D levels were estimated along with bone mineral density (DEXA scan).
Results : Male:female ratio was 2:1, the KT/V was more than 1 for all the subjects, Calcium × phosphorus product was < 55 mg2 /dl2 in 16 subjects and > 55mg2 / dl2 in two of them. The intact PTH values were less than 100pg/ml in 5, 100-300pg/dl in 10 and > 300pg/dl in 3. The 25 OH D levels were <30ng/ml in 16 (89%). BMD by DEXA revealed osteoporosis in 50% and osteopenia in 50% subjects.
Conclusion : Majority of patients were 25 OH D deficient. They had abnormal bone mineral density documented as osteopenia/osteoporosis. In most of them the corrected Ca × PO4 product was within normal limits. Intact PTH levels were suggestive of hyperdynamic bone disease in 3, hypodynamic/adynamic bone disease in 5 of them.
Copyright © 2008 by The Indian Society of Organ Transplantation