Prevalence of Musculoskeletal Manifestations in Adult Kidney Transplant’s Recipients: A Systematic Review

Abstract

Background and Objectives: The musculoskeletal (MSK) manifestations in the kidney transplant recipient (KTxR) could lead to decreased quality of life and increased morbidity and mortality. However, the prevalence of these MSK manifestations is still not well-recognized. This review aimed to investigate the prevalence and outcomes of MSK manifestations in KTxR in the last two decades. Materials and Methods: Research was performed in EBSCO, EMBASE, CINAHL, PubMed/MEDLINE, Cochrane, Google Scholar, PsycINFO, Scopus, Science Direct, and Web of Science electronic databases were searched during the years 2000–2020. Results: The PRISMA flow diagram revealed the search procedure and that 502 articles were retrieved from the initial search and a total of 26 articles were included for the final report in this review. Twelve studies reported bone loss, seven studies reported a bone pain syndrome (BPS) or cyclosporine-induced pain syndrome (CIPS), and seven studies reported hyperuricemia (HU) and gout. The prevalence of MSK manifestations in this review reported as follow: BPS/CIPS ranged from 0.82% to 20.7%, while bone loss ranged from 14% to 88%, and the prevalence of gout reported in three studies as 7.6%, 8.0%, and 22.37%, while HU ranged from 38% to 44.2%. Conclusions: The post-transplantation period is associated with profound MSK abnormalities of mineral metabolism and bone loss mainly caused by corticosteroid therapy, which confer an increased fracture risk. Cyclosporine (CyA) and tacrolimus were responsible for CIPS, while HU or gout was attributable to CyA. Late diagnosis or treatment of post-transplant bone disease is associated with lower quality of life among recipients

Prevalence of Musculoskeletal and Metabolic Disorders in Kidney Transplant Recipients: A Systematic Review and Meta-Analysis

“…This BMD alteration is associated with both osteopenia and osteoporosis, as mentioned above, with various metabolic disturbances that occur after renal transplantation [ 4 ]. Although there are also several risk factors, such as advanced age, sex, and ethnicity of the patient [ 4 , 6 ], the main underlying factor for BMD loss is treatment with glucocorticoids after transplantation. Glucocorticoids inhibit bone tissue formation and increase osteoclast activity by decreasing the formation and differentiation of osteoblasts [ 69 ].…”

“…Despite the improvement in renal function after transplantation, hyperparathyroidism may develop due to a number of factors, including the high levels of parathyroid hormone (PTH) prior to transplantation, the prolonged period of renal disease and dialysis, the degree of hyperplasia of the parathyroid gland or the decrease in vitamin D [2,[62][63][64]. PTH levels begin to decline during the first 3-6 months after the procedure, but according to the article published by Hassan et al [6], high PTH levels can still be found in 30%-60% of patients 1 year after transplantation [6]. This alteration is also associated with hypercalcemia and hypophosphatemia, among others, which could lead to loss of BMD [2].…”

“…Musculoskeletal disorders include a group of pathologies suffered by many patients after surgery, the exact prevalence of which is not yet well known [ 6 ]. This group includes disorders such as osteopenia, osteoporosis, and sarcopenia, which involve both a reduction in bone density and a reduction in strength and muscle mass, respectively [ 7 ].…”

Long-lasting severe knee pain in a SLE patient after renal transplantation: what is the reason? A case report and literature review

“…None of them were restricted to patients with lupus. The recent paper by Haasan et al provides an up-to-date review of the literature on causes of musculoskeletal disorders in renal transplant patients [ 2 ]. The authors concluded that bone loss ranged from 14 to 88%, calcineurin inhibitor pain syndrome (CIPS) ranged from 0.82% to 20.7%, while the prevalence of gout ranged from 7.6% to 22.37%.…”

Relation of testosterone level and other factors with bone mineral density in male kidney transplant recipients: a cross-sectional study

“…Currently, kidney transplantation is the best management option for patients diagnosed with end-stage kidney disease (ESKD), as it is associated with a better quality of life and more prolonged survival compared to other management options [1]. However, bone affection is frequently encountered in kidney transplant recipients [2]. Bone mass is markedly reduced within the first year after transplantation [3,4], which can lead to increased fracture risk in this population [5].…”