Necrosis of the femoral head after renal transplantation

Predictors of Avascular Necrosis after Kidney Transplantation

“…Although several studies revealed that cumulative corticosteroid doses were higher among patients with AVN (14,23), the current study suggested that cumulative corticosteroid dose itself was not a risk factor for AVN development.…”

Bone disease in post-transplant patients

“…The vasoconstrictive effects of cyclosporine may increase the risk of osteonecrosis, and sirolimus may affect osteonecrosis by altering the lipid profile or by potentiating the influence of calcineurin inhibitors [69] (Table 1). In a retrospective study that compared 374 kidney transplant recipients receiving high-dose steroid (average, 12.5 g during the first year) with 376 patients receiving low-dose steroid (6.5 g), necrosis of the femoral head in the high-dose group was much more frequent [70]. However, reduction of steroid dose has little effect once osteonecrosis develops, and most patients eventually require joint replacement [71].…”

Incidence and radio-uptake patterns of femoral head avascular osteonecrosis at 1 year after renal transplantation: a prospective study with planar bone scintigraphy

“…Lausten et al [17], in a retrospective study of the medical records of 750 patients, showed an 11.2% incidence of symptomatic osteonecrosis with high-dose glucocorticoids (cumulative mean dose of prednisolone 12.5 g at 1 year post-transplant) and 5.1% with low-dose (cumulative mean dose of prednisolone average dose 6.5 g). The cohort of Kopecky et al [9], with an osteonecrosis incidence of 22%, had a prednisolone equivalent dose of 7 ± 3.25 g prednisolone during the first 90 days after transplantation.…”