|
KMID : 0361120170310040200
|
|
Korean Journal of Transplantation
2017 Volume.31 No. 4 p.200 ~ p.206
|
|
|
Predictors of Avascular Necrosis after Kidney Transplantation
|
|
Ko Young-Min
Kwon Hyun-Wook
Chun Sung-Jin
Kim Young-Hoon
Choi Ji-Yoon
Shin Sung
Jung Joo-Hee
Park Su-Kil
Han Duck-Jong
|
|
|
Abstract
|
|
|
Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known.
Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT.
Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P＜0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67).
Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.
|
|
|
KEYWORD
|
|
|
Osteonecrosis, Kidney transplantation, Female, Immunosuppression
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|
|