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IF 3.4 3区医学 Q2 GERIATRICS & GERONTOLOGY

Aging Clinical and Experimental Research Pub Date : 2025-04-12 DOI:10.1007/s40520-025-03018-3

Antoine Bouquegneau, Marie Ernst, Olivier Malaise, Laurence Seidel, Jean-François Kaux, Jean-Yves Reginster, Etienne Cavalier, Clio Ribbens, François Jouret, Laurent Weekers, Pierre Delanaye

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引用次数: 0

摘要

背景肾移植（KTx）后骨异常很常见，并与骨折风险增加有关。肾移植后骨质异常的病理生理学是多因素的，其中皮质类固醇（CS）治疗是导致骨矿物质密度（BMD）下降的一个因素。本研究旨在评估停用 CS 与继续 CS 治疗对肾移植受者（KTRs）队列中 BMD 变化的影响。方法我们回顾性分析了 2005 年至 2021 年间接受 KTx 的 132 名患者的 BMD 数据。在 KTx 时（T0）和 KTx 术后两年（2yT），我们使用双能 X 射线吸收测量法对 BMD 进行了评估。患者被分为两组：在 KTx 术后第一年内停止 CS 治疗的患者（CS-）和继续 CS 治疗的患者（CS+）。结果KTx 时的平均年龄为 52.2（± 12.6）岁，62.1% 的患者为男性。总体而言，腰椎（LS）的 BMD 明显增加，但桡骨的 BMD 在 2yT 时有所下降，而髋关节部位的 BMD 保持稳定。44.7% 的患者在 T0 至 2yT 期间停用了 CS，平均停用时间为 KTx 后 6.3（± 4.9）个月。CS组在LS和髋关节部位的BMD有明显改善。结论 KTx 后停用 CS 对 BMD 有积极影响，而较高的 CS 累积剂量与较大的 BMD 损失有关。这些研究结果强调了尽量减少 CS 暴露以保护 KTR 骨健康的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Impact of corticosteroid withdrawal on bone mineral density after kidney transplantation

Background

Bone abnormalities are common after kidney transplantation (KTx) and are associated with an increased risk of fractures. The pathophysiology of post-KTx bone disorders is multifactorial, with corticosteroid (CS) therapy being a contributor to the loss of bone mineral density (BMD). This study aimed to evaluate the impact of CS withdrawal versus continued CS therapy on BMD evolution in a kidney transplant recipients (KTRs) cohort.

Methods

We retrospectively analyzed BMD data from 132 patients who underwent KTx between 2005 and 2021. BMD was assessed using dual-energy X-ray absorptiometry at the time of KTx (T0) and two-years post-KTx (2yT). Patients were categorized into two groups: those who discontinued CS (CS−) within the first-year post KTx and those who continued CS therapy (CS+).

Results

The mean age at KTx was 52.2 (± 12.6) years, and 62.1% of the patients were male. Overall, BMD increased significantly at the lumbar spine (LS) but decreased at the radius at 2yT, while BMD at the hip site remained stable. CS was discontinued in 44.7% of patients between T0 and 2yT, with an average discontinuation time of 6.3 (± 4.9) months post-KTx. The CS− group showed significant BMD improvements at LS and hip sites. In a multivariate analysis, a higher cumulative CS dose was independently associated with a larger BMD decline.

Conclusions

CS withdrawal after KTx positively impacts BMD, while higher cumulative CS doses are associated with a greater BMD loss. These findings underscore the importance of minimizing CS exposure to preserve bone health in KTRs.

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来源期刊

Aging Clinical and Experimental Research 医学-老年医学

CiteScore

7.90

自引率

5.00%

发文量

283

审稿时长

1 months

期刊介绍： Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.