| ObjectiveThrough retrospective research on the clinical data of kidney transplant recipients,the relevant factors affecting the prognosis of renal bone disease after kidney transplantation are analyzed,and corresponding clinical guidance is provided for kidney transplant patients.MethodsA total of 109 renal transplant patients(including those who underwent renal transplant surgery in our hospital and outside hospitals)who underwent renal transplant surgery since 01 January 2015 and had postoperative follow-up in the urology outpatient clinic of kanggang hospital,Inner Mongolia,between October2019 and October 2020 were selected,and the following patients’ gender,age,graft age,height,weight,body mass index,primary renal disease,preoperative values were collected.Dialysis method,dialysis time and other basic information,the patients’ osteocalcin,calcitonin,parathyroid hormone,vitamin D,blood biochemistry,alkaline phosphatase,blood drug concentrations and other indicators were detected,bone densitometry was performed using dual light energy X-ray absorptiometry.Results1.A total of 109 renal transplantation recipients were included in this study,ranging in age from 23 to 66 years old,with an average age of 43.77±8.481 years old,height of 168.39±7.169 cm,weight of 62.55±12.035 kg,and age of transplantation of20.64±19.239 months.There were 70 male patients(64.22%)and 39 female patients(35.78%).Among male patients,21 cases(19.27%)were older than 50 years old,49cases(44.95%)were younger than 50 years old.Among female kidney transplant recipients,10 cases(9.17%)were postmenopausal women,and 29 cases(26.61%)were menstrual regulars.2.According to patients with renal transplant recipients BMD test results will be divided into normal bone mass and bone mass loss group,will be the basic information of the two groups of patients and test results of chi-square test and independent samples t test,the results showed that age,kidney source,magnesium and other indicators associated with bone mineral density determination results,bone mass loss of patients age,higher and higher concentration of magnesium,statistically significant difference(P < 0.05).3.According to the age of kidney transplantation recipients,the patients were divided into five groups.One-way analysis of variance showed that there were statistically significant differences in BMD values at different sites among patients of different ages(P < 0.05).According to the age of transplantation after kidney transplantation,the patients were divided into seven groups.One-way analysis of variance showed that there were statistically significant differences in bone mineral density values at different sites of patients with different age of transplantation(P <0.05).According to the preoperative dialysis time of the kidney transplant recipients,the patients were divided into six groups.One-way analysis of variance showed that the differences of bone mineral density values in different parts of the patients with different preoperative dialysis time were statistically significant(P < 0.05).According to the recovery time of renal function after kidney transplantation,the patients were divided into six groups.One-way analysis of variance(ANOVA)showed that there were statistically significant differences in BMD values in different parts of patients with different recovery time of renal function(P < 0.05).4.According to the way of dialysis patients with preoperative group(hemodialysis,peritoneal dialysis,hemodialysis + peritoneal dialysis),sex(male,female),kidney source group(after the death of relatives for kidney,citizens for kidney)smoking group(with),history of drinking group(with),the female menopause or not grouping(postmenopausal,menstruating),immune suppression scheme grouping spore element,tacrolimus(ring)the comparison of bone mineral density values for each part,the analysis results show: different ways of preoperative dialysis parts bone mineral density is no statistical difference between groups(P >0.05);There was no significant difference in bone mineral density among different sex groups(P > 0.05).In right femoral neck,after the death of citizens for the renal group of bone mineral density is lower than the relatives for the group,with statistical difference(P < 0.05),while in small 4 1-waist and the comparison of the left femoral neck bone mineral density between the two groups had no statistical difference(P >0.05),according to different sources of kidney group on postoperative renal function recovery time and postoperative hormone,accumulative total usage results find relatives for kidney patients postoperative renal function recovery time and postoperative hormone accumulative total amount was significantly lower than citizens for kidney patients after death,statistically significant difference(P < 0.05);There was no significant difference in bone mineral density between the groups with or without smoking history(P > 0.05).There was no significant difference in BMD between groups with or without previous drinking history(P > 0.05).At the left femoral neck and right femoral neck,the BMD of the postmenopausal group was lower than that of the pre-menopausal group,with statistical difference(P < 0.05),while there was no statistical difference in BMD between the two groups in the L1-L4area(P > 0.05).BMD of the tacrolimus group at the left femoral neck was lower than that of the cyclosporine group,with statistical difference(P < 0.05).BMD of the two groups at the L1-L4 and right femoral neck showed no statistical difference(P >0.05).5.The results of bone mineral density(BMD)were used as dependent variables,and the age,transplant age,preoperative dialysis time,postoperative renal function recovery time,kidney source,hormone dosage,menopause,immunosuppressive regimen and other factors of renal transplant recipients were used as independent variables for logistic regression analysis.The results showed that menopause was negatively correlated with BMD(P = 0.014),The difference was statistically significant.6.According to the age of transplantation after kidney transplantation,the patients were divided into seven groups.The analysis results showed that there were significant differences in 25-OH-VD and magnesium among the patients of different age groups(P < 0.05),while there were no significant differences in other bone metabolism indexes and blood biochemical indexes among the groups(P > 0.05).ConclusionFor different ages,different age,different time and different kidney dialysis preoperative function of each part of the recovery time of patients with bone mineral density values have significant differences,as the growth of the age,preoperative dialysis time and the increase of postoperative renal function recovery time,bone mineral density values gradually reduced,with the increase of age of transplantation,bone mineral density value increase.The menopause of female kidney transplant recipients is also one of the factors affecting bone metabolism.The dosage of glucocorticoid and the type of calcineurin inhibitor also have certain influence on bone metabolism.Therefore,for patients with end-stage renal disease should shorten the dialysis time,kidney transplantation as soon as possible;Bone mineral density measurement for kidney transplant recipients who shall regularly and osteocalcin,calcitonin,parathyroid hormone,vitamin D,blood biochemistry,alkaline phosphatase,such as indicators of detection,which will help the patients after renal transplantation of metabolic bone disease,early detection,early diagnosis,early treatment,reduce the related complications,improve the quality of life of patients. |
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