Trabecular bone architecture in female renal allograft recipients-- assessed by computed tomography

BACKGROUND: Osteopenia with decreased bone mineral density (BMD) is afrequent finding in renal allograft recipients. Data concerning the bonearchitecture in these patients do not exist, however. METHODS: We comparedthe bone architecture of 33 randomly assigned women (age 49 +/- 12 years),who had received renal allografts 5.6 +/- 5.3 years before theinvestigation, with 74 women (age 50 +/- 14 years) who were admitted forosteodensitometry. All patients underwent single-energy computed tomography(SEQCT) and a midvertebral high-resolution tomography withcomputer-assisted analysis of the trabecular vertebral body architecture.RESULTS: Progressive alteration of bone architecture was associated withincreasing vertebral height loss of the vertebral body. Height reduction ofa vertebral body of more than 15% was associated with a significantly lowerBMD (-2.3 +/- 0.8 versus -1.1 +/- 1.1 standard deviations below normalBMD), a lower trabecular bone area (13 +/- 8% versus 42 +/- 22%) and alower trabecular diameter (1.4 +/- 0.5 mm versus 2.2 +/- 0.8 mm) comparedto recipients without height reduction. In comparison to a matched group ofpatients with similarly reduced BMD (1.1 +/- 1.2 versus 1.2 +/- 1.1 SDbelow normal BMD), renal allograft recipients showed a lower number oftrabecular plates (5.6 +/- 3.1 versus 7.0 +/- 3.7) and a smallerintertrabecular surface (54 +/- 116 mm versus 75 +/- 138 mm). CONCLUSIONS:Alterations of bone architecture in renal allograft recipients wereassociated with progressive vertebral height loss. Despite similar bonemineral density, differences of bone architecture could be observed betweenrenal allograft recipients and patients with osteoporosis.