Nefrología (English Edition) (May 2016)

Mineral metabolism disorders, vertebral fractures and aortic calcifications in stable kidney transplant recipients: The role of gender (EMITRAL study)

  • Armando Torres,
  • Vicens Torregrosa,
  • Roberto Marcen,
  • Josep María Campistol,
  • Manuel Arias,
  • Domingo Hernández,
  • Constantino Fernández,
  • Nuria Esforzado,
  • Raphael Paschoalin,
  • Nuria Pérez,
  • Ana Isabel García,
  • Montserrat Del Amo,
  • Jaume Pomés,
  • Ana González Rinne,
  • Domingo Marrero,
  • Estefanía Pérez,
  • Fernando Henríquez,
  • Juan Manuel Díaz,
  • Irene Silva,
  • Verónica López,
  • Manuel Perello,
  • David Ramos,
  • Isabel Beneyto,
  • José María Cruzado,
  • Alberto Martínez Castelao,
  • Juan Bravo,
  • Minerva Rodríguez,
  • Carmen Díaz,
  • Josep Crespo,
  • Fernando Anaya,
  • María Luisa Rodríguez,
  • Juan José Cubero,
  • Pilar Pascual,
  • Rafael Romero,
  • Amado Andrés Belmonte,
  • María Dolores Checa,
  • Carlos Jiménez,
  • Fernando Escuin,
  • Marta Crespo,
  • Marisa Mir,
  • Gonzalo Gómez,
  • Beatriz Bayes,
  • María José González,
  • Alex Gutiérrez,
  • Marta Cuberes,
  • Alberto Rodríguez Benoit,
  • Teresa García,
  • Francisco Llamas,
  • Agustín Ortega,
  • José Luis Conde,
  • Carlos Gómez Alamillo

DOI
https://doi.org/10.1016/j.nefroe.2016.05.002
Journal volume & issue
Vol. 36, no. 3
pp. 255 – 267

Abstract

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Background and objectives: The relationship between mineral metabolism disorders, bone fractures and vascular calcifications in kidney transplant recipients has not been established. Method: We performed a cross-sectional study in 727 stable recipients from 28 Spanish transplant clinics. Mineral metabolism parameters, the semi-quantification of vertebral fractures and abdominal aortic calcifications were determined centrally. Results: Vitamin D deficiency (25OHD3 <15 ng/ml) was more common in female recipients at CKD-T stages I–III (29.6% vs 44.4%; p = 0.003). The inverse and significant correlation between 25OHD3 and PTH was gender-specific and women exhibited a steeper slope than men (p = 0.01). Vertebral fractures (VFx) with deformity grade ≥2 were observed in 15% of recipients. Factors related to VFx differed by gender; in males, age (OR 1.04; 95% CI 1.01–1.06) and CsA treatment (OR: 3.2; 95% CI: 1.6–6.3); in females, age (OR 1.07; 95% CI: 1.03–1.12) and PTH levels (OR per 100 pg/ml increase: 1.27; 95% CI: 1.043–1.542). Abdominal aortic calcifications were common (67.2%) and related to classical risk factors but not to mineral metabolism parameters. Conclusions: Vitamin D deficiency is more common among female kidney transplant recipients at earlier CKD-T stages, and it contributes to secondary hyperparathyroidism. Prevalent vertebral fractures are only related to high serum PTH levels in female recipients.

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