Authors: P Wong P J Fuller M T Gillespie V Kartsogiannis B J Strauss D Bowden F Milat
Publish Date: 2013/01/05
Volume: 24, Issue: 7, Pages: 1965-1971
Abstract
Thalassemia bone disease is well described but the prevalence of nephrolithiasis has not been characterized The association between nephrolithiasis reduced bone density and increased fractures has been demonstrated through this retrospective study of 166 participants with transfusiondependent thalassemia The findings support the need for increased vigilance of kidney and bone disease in this cohortPrevious studies have revealed that thalassemia is associated with reduced bone mineral density BMD and fractures Many causes are implicated including hypogonadism growth hormone deficiency marrow expansion and iron overload Nephrolithiasis is associated with reduced BMD and increased fractures in the general population However the prevalence of nephrolithiasis and its association with bone density and fractures have not been characterized in thalassemiaWe have addressed this question by performing a retrospective cohort study of 166 participants with transfusiondependent thalassemia who had undergone dualenergy Xray absorptiometry between 2009 and 2011 Logistic regression modeling was used to adjust for potential confoundersWe found a high prevalence of kidney stones 181 which was greater in males compared to females 287 vs 97 respectively Renal stones were associated with reduced femoral neck Zscore and fractures in men after adjusting for potential confounders These results indicate that nephrolithiasis is highly prevalent in patients with transfusiondependent thalassemia and is significantly associated with reduced BMD and increased fracturesP W is supported by an Australian Postgraduate Scholarship and Royal Australian College of Physicians and Osteoporosis Australia scholarship This work was supported through an unrestricted educational grant from Servier Merck Sharp and Dohme and SanofiAventis to F M and P W and a National Health and Medical Research Council Australia Senior Principal Research Fellowship to P J F grant number 1002559 Prince Henry’s Institute is supported by the Victorian Government’s Operational Infrastructure Support program
Keywords: