ArticlePloS one2019
Avascular osteonecrosis in kidney transplant recipients: Risk factors in a recent cohort study and evaluation of the role of secondary hyperparathyroidism.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- No evidence of genetic causality between diabetes and osteonecrosis: a bidirectional two-sample Mendelian randomization analysis.Journal of orthopaedic surgery and research · 2023Pooled it
- Does Diabetes Mellitus Increase the Risk of Avascular Osteonecrosis? A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Revisiting the clinical predictors of avascular necrosis after kidney transplantation.International urology and nephrology · 2026Article
- Patients with prior solid organ transplant who undergo total joint arthroplasty can expect promising patient-reported outcomes and low mortality at 1-year.Journal of clinical orthopaedics and trauma · 2025Article
- Avascular necrosis in kidney transplant recipients: Incidence and risk factors in the modern immunosuppression era.Joint diseases and related surgery · 2025Article
- Long-lasting severe knee pain in a SLE patient after renal transplantation: what is the reason? A case report and literature review.Rheumatology international · 2022Review
- Current status of glucocorticoid usage in solid organ transplantation.World journal of transplantation · 2021Review
- Article
- Risk factors for symptomatic Avascular Necrosis (AVN) in a multi-ethnic Systemic Lupus Erythematosus (SLE) cohort.PloS one · 2021Article
- Incidence and risk factors for osteonecrosis of the hip in renal transplant patients: a prospective single-centre study.International orthopaedics · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Avascular osteonecrosis (AVN) is a bone complication that indicates poor functional prognosis. Modern immunosuppressive and steroid-sparing drugs have significantly lowered the occurrence of AVN after kidney transplantation (KT). However, recent data on its incidence rates and risk factors are lacking. Using a large, recent cohort, we sought to investigate AVN incidence and risk factors, with a special focus on mineral and bone disorders. We conducted a cohort study in 805 patients who underwent KT between 2004 and 2014. AVN was identified in 32 patients (4%): before KT in 15 (1.8%) and after KT in 18 (2.2%) cases, including one patient with both. In the group with post-KT AVN, the median time intervals from KT to 1) first symptoms and 2) AVN diagnosis were 12 months [1-99] and 20 months [4-100], respectively. Being overweight/obese, having pre-transplant diabetes or hyperparathyroidism at transplantation, developing acute rejection, and receiving higher cumulative corticosteroid doses were associated with AVN occurrence. Multivariate analysis revealed that BMI ≥ 26 kg/m2 and higher cumulative corticosteroid doses were predictive of AVN. In conclusion, overweight/obesity is a strong risk factor for AVN. Despite a low maintenance dose, the use of corticosteroids-mostly for treatment of acute rejection-remains an independent risk factor.
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