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TUĞLULAR, ZÜBEYDE SERHAN

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TUĞLULAR

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ZÜBEYDE SERHAN

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Author: BUĞDAYCI, ONUR × Subject: DISEASE ×

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    PublicationOpen Access
    Low bone density, vertebral fracture and FRAX score in kidney transplant recipients: A cross-sectional cohort study
    (PUBLIC LIBRARY SCIENCE, 2021-04-30) VELİOĞLU, ARZU; Velioglu, Arzu; Kaya, Burcu; Aykent, Basar; Ozkan, Bige; Karapinar, Melis Sevil; Arikan, Hakki; Asicioglu, Ebru; Bugdayci, Onur; Yavuz, Dilek Gogas; Tuglular, Serhan
    Background Kidney transplantation (KT) recipients are at increased risk of low bone density (LBD) and fractures. In this retrospective study, we investigated bone mineral density (BMD), vertebral fractures, calculated risk for major osteoporotic fractures (MOF), and hip fractures in the KT recipients. Patients-method Patients who completed at least one year after KT were included in the analysis. Demographic, clinical, and laboratory data were recorded. Measurements of BMD were performed by dual-energy X-ray absorptiometry. Vertebral fractures were assessed using semi-quantitative criteria with conventional radiography. The ten-year risk for MOF and hip fracture were calculated using the FRAX@ tool with BMD. Results One hundred fifty-three KT recipients were included in the study. The population included 77 women. The mean age at evaluation was 46,511,9 years. Seventy-eight (50.9%) patients had normal femoral neck BMD while osteoporosis and osteopenia at the femoral neck were present in 12 (7.8%) and 63 (41.1%) of the patients, respectively. Age at evaluation was the risk factor for LBD (OR 1.057; 95% CI 1.024-1.091; p = 0.001). In female KT recipients, LBD was principally affected by menopausal status whereas in males, mammalian target of rapamycin (mTOR) inhibitor use and lower BMI levels were the risk factors. The prevalent vertebral fracture was found in 43.4% of patients. In multivariate analysis, only steroid use (OR 0.121; 95% CI 0.015-0.988; p = 0.049) was found to be associated with prevalent fracture. Among all KT recipients, 1.9% had a high MOF probability (>= 20% risk of fracture), and 23.5% had high hip fracture probability (>= 3% risk of hip fracture) according to FRAX. Conclusion Exploring the prevalence of LBD and vertebral fracture and the risk factors would help clinicians to modify long-term follow-up strategies. Furthermore, the high hip fracture risk probability in our cohort suggested that there is a need for longitudinal studies to confirm the validity of the FRAX tool in the transplant population.
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    PublicationOpen Access
    Clinical predictors of incipient vertebral fractures and bone mineral density in kidney transplant patients
    (2022-09-01) APAYDIN, TUĞÇE; VELİOĞLU, ARZU; YAVUZ, DİLEK; BUĞDAYCI, ONUR; TUĞLULAR, ZÜBEYDE SERHAN; YAVUZ D., Aydin K., Apaydin T., VELİOĞLU A., Mert M., Pekkolay Z., Parmaksiz E., Mese M., Pazir A. E., Aydin E., et al.
    © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Purpose: Kidney transplant recipients are prone to metabolic bone diseases and consequent fractures. This study aimed to evaluate the incidence of incipient vertebral fractures, osteopenia, osteoporosis, and the clinical factors associated with incipient vertebral fractures in a group of kidney transplant patients. Methods: Two hundred sixty-four patients (F/M 124/140, 45.3 ± 13 years) who had undergone kidney transplantation in tertiary care centers were included. Vertebral fractures were assessed semiquantitatively using conventional thoracolumbar lateral radiography in 202 of the patients. Results: Vertebral fractures were observed in 56.4% (n = 114) of the study group. The frequency of osteoporosis was 20.0% (53 of 264 patients), and osteopenia was 35.6% (94 of 264 patients). Bone mineral density (BMD) levels were in the normal range in 40.3% (n = 46) of the subjects with vertebral fractures. It was in the osteoporotic range in 20.1% (n = 23) and the osteopenic range in 40.3% (n = 46). Vertebral fractures were associated with age, duration of hemodialysis, BMI, and femoral neck Z score (R2 37.8%, p = 0.027). Conclusion: As incipient vertebral fractures can be observed in patients with normal BMD levels in kidney transplant recipients, conventional X-ray screening for vertebral fractures may be beneficial for a proper therapy decision of metabolic bone disease in kidney transplant recipients.