Charcot Neuroarthropathy After Simultaneous Pancreas-Kidney Transplant

Charcot Neuroarthropathy After Simultaneous Pancreas-Kidney Transplant

Author Rangel, Erika B. Autor UNIFESP Google Scholar
Sa, Joao R. Autor UNIFESP Google Scholar
Gomes, Samirah A. Autor UNIFESP Google Scholar
Carvalho, Aluizio B. Autor UNIFESP Google Scholar
Melaragno, Claudio S. Autor UNIFESP Google Scholar
Gonzalez, Adriano M. Autor UNIFESP Google Scholar
Linhares, Marcelo M. Autor UNIFESP Google Scholar
Medina-Pestana, Jose O. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Background. Immunosuppressive regimen is associated with several metabolic adverse effects. Bone loss and fractures are frequent after transplantation and involve multifactorial mechanisms.Methods. A retrospective analysis of 130 patients submitted to simultaneous pancreas-kidney transplantation (SPKT) and an identification of risk factors involved in de novo Charcot neuroarthropathy by multivariate analysis were used; P<0.05 was considered significant.Results. Charcot neuroarthropathy was diagnosed in 4.6% of SPKT recipients during the first year. Cumulative glucocorticoid doses (daily dose plus methylprednisolone pulse) during the first 6 months both adjusted to body weight (978 mg/kg) and not adjusted to body weight were associated with Charcot neuroarthropathy (P=0.001 and P<0.0001, respectively). Age, gender, race, time on dialysis, time of diabetes history, and posttransplantation hyperparathyroidism were not related to Charcot neuroarthropathy after SPKT.Conclusions. Glucocorticoids are the main risk factors for de novo Charcot neuroarthropathy after SPKT. Protocols including glucocorticoid avoidance or minimization should be considered.
Keywords Charcot neuroarthropathy
Glucocorticoids
Nonvertebral fractures
Pancreas-kidney transplantation
Language English
Date 2012-09-27
Published in Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 94, n. 6, p. 642-645, 2012.
ISSN 0041-1337 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 642-645
Origin http://dx.doi.org/10.1097/TP.0b013e31825cadbb
Access rights Closed access
Type Article
Web of Science ID WOS:000309223100019
URI http://repositorio.unifesp.br/handle/11600/35286

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