Factors effecting bone loss after transplantation in patients with renal transplantation and determination of their relationship with blood gas

Osteoporosis is a complication of renal transplantation. The reduction in bone mass is particularly evident during the first 6-12 months after transplantation, then continues at a lower rate. The aim of our study is to determine the frequency of bone loss and related factors in patients undergoing renal transplantation (RTR). 150 RTRs were evaluated in our study. Patients; age, gender, body mass index (BMI), primary disease, type of dialysis, duration of dialysis, type of transplantation, duration of renal transplantation, steroid use, immunosuppressive history, cumulative steroid dose, immunosuppressive therapy taken by the patient regimen, diabetes history, dual-energy x-ray absorptiometry , glomerular filtration rate (GFR) and biochemical markers were evaluated. Osteoporosis detected in 24.6% of the patients in L1-L4 total bone mineral densitometry(BMD) measurement,and 21.3% of the patients in femoral neck BMD measurement. The primary diseases of the patients, cumulative steroid dose, GFR, albumin, alkaline phosphatase, phosphorus and calcium levels, transplantation type, steroid history, immunosuppressive history and immunosuppressive regimens, and lumbar spine and femur neck BMD values were not found significant (p >0.05). Peritoneal dialysis (PD) and prolonged transplantation time in the lumbar spine, bicarbonate (HCO3) level in the femoral neck, BMI in both regions were associated with increased BMD (p<0.05). Acidosis in the lumbar spine, advanced age and prolonged dialysis time in the femoral neck, high parathormone level was found to be associated with decreased BMD in both regions (p <0.05). In our study, acidosis was associated with bone loss in RTRs and physicians' awareness of this issue may be low, especially in patients with partially preserved GFR. Blood gas and HCO3 values in RTRs should be screened at regular intervals, and if HCO3 decreased, they should be treated.