Pediatric Radiology

, Volume 35, Issue 5, pp 489–494

Evaluation of bone-mineral density by digital X-ray radiogrammetry (DXR) in pediatric renal transplant recipients

Authors

    • Department of Pediatric Radiology, Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University Jena
  • Ulrike John
    • Department of Pediatric NephrologyFriedrich-Schiller-University Jena
  • Joachim Boettcher
    • Department of Pediatric Radiology, Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University Jena
  • Ansgar Malich
    • Department of Pediatric Radiology, Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University Jena
  • Alexander Pfeil
    • Department of Pediatric Radiology, Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University Jena
  • Rüdiger Vollandt
    • Institute of Medical Statistics, Computer Sciences and DocumentationFriedrich-Schiller-University Jena
  • Joachim Misselwitz
    • Department of Pediatric NephrologyFriedrich-Schiller-University Jena
  • Werner A. Kaiser
    • Department of Pediatric Radiology, Institute of Diagnostic and Interventional RadiologyFriedrich-Schiller-University Jena
Original Article

DOI: 10.1007/s00247-004-1381-7

Cite this article as:
Mentzel, H., John, U., Boettcher, J. et al. Pediatr Radiol (2005) 35: 489. doi:10.1007/s00247-004-1381-7

Abstract

Background: Loss of bone mass and increased fracture risk are known complications after renal transplantation in adults. Risk factors include donor source, dialysis status prior to transplantation, aetiology of renal disease, transplant rejection and drug therapy, particularly steroids. Objective: In this preliminary study of quantification of bone loss in children after renal transplantion, we evaluated the applicability of digital X-ray radiogrammetry (DXR) of hand radiographs to estimate cortical bone mineral density (DXR-BMD). Materials and methods: A total of 23 renal transplant recipients (9 girls, 14 boys; age 6.5–20 years, median 16.3 years) underwent DXR measurements for calculation of DXR-BMD and metacarpal index (DXR-MCI) using radiographs of the non-dominant left hand. The duration between transplantation and the DXR evaluation, the duration of dialysis and medication were considered. The results were compared to a local age-matched and gender-matched reference data base. Results: Our study revealed a significant decrease in bone mineral density compared to an age-matched and sex-matched normal population (P<0.05). In three patients the DXR-BMD was reduced more than −2.5 SD. In 12 patients the DXR-BMD was between −1 and −2.5 SD, and in 7 patients the DXR-BMD was in the normal range. In one patient, evaluation was not possible. Fractures were documented in three patients following transplantation. Reduced DXR-BMD was not significantly associated with immunosuppressive therapy or the duration of dialysis, and there was no significant correlation between DXR-BMD and the time between transplantation and DXR evaluation. Conclusions: Paediatric renal transplant patients show reduced DXR-BMD. In this preliminary study we demonstrated that DXR-BMD seems to be a reliable technique for quantification of demineralisation following renal transplantation in children.

Keywords

Renal transplantationDigital X-ray radiogrammetryBone-mineral densityMetacarpal indexChildren

Copyright information

© Springer-Verlag 2004