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

doi:10.3390/medicina57060525

. 2021 May 23;57(6):525.

doi: 10.3390/medicina57060525.

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

Adla B Hassan^{1

2}, Kanz W Ghalib¹, Haitham A Jahrami^{1

3}, Amgad E El-Agroudy^{1

2}

Affiliations

¹ College of Medicine and Medical Sciences, Arabian Gulf University (AGU), 323 Manama, Bahrain.
² Department of Internal Medicine, University Medical Center (UMC), King Abdullah Medical City (KAMC), 323 Manama, Bahrain.
³ Ministry of Health, 410 Manama, Bahrain.

PMID: 34071098
PMCID: PMC8224589
DOI: 10.3390/medicina57060525

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

Adla B Hassan et al. Medicina (Kaunas). 2021.

. 2021 May 23;57(6):525.

doi: 10.3390/medicina57060525.

Authors

Adla B Hassan^{1

2}, Kanz W Ghalib¹, Haitham A Jahrami^{1

3}, Amgad E El-Agroudy^{1

2}

Affiliations

¹ College of Medicine and Medical Sciences, Arabian Gulf University (AGU), 323 Manama, Bahrain.
² Department of Internal Medicine, University Medical Center (UMC), King Abdullah Medical City (KAMC), 323 Manama, Bahrain.
³ Ministry of Health, 410 Manama, Bahrain.

PMID: 34071098
PMCID: PMC8224589
DOI: 10.3390/medicina57060525

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.

Keywords: CyA-induced pain syndrome; bone pain; hyperuricemia; musculoskeletal; osteoporosis; renal transplant.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
PRISMA 2020 Flow Diagram for newly developed musculoskeletal manifestations in adult post kidney transplant Recipients (KTxR).

See this image and copyright information in PMC

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References

1. Pichette V., Bonnardeaux A., Prudhomme L., Gagne M., Cardinal J., Ouimet D. Long-term bone loss in kidney transplant recipients: A cross-sectional and longitudinal study. Am. J. Kidney Dis. 1996;28:105–114. doi: 10.1016/S0272-6386(96)90138-9. - DOI - PubMed
1. Kart-Koseoglu H., Yucel A.E., Isiklar I., Turker I., Akcali Z., Haberal M. Joint pain and arthritis in renal transplant recipients and correlation with cyclosporine therapy. Rheumatol. Int. 2003;23:159–162. doi: 10.1007/s00296-002-0283-y. - DOI - PubMed
1. Braun W.E., Richmond B.J., Protiva D.A., Gifford R.W., Jr., Straffon R.A. The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine. Transpl. Proc. 1999;31:1366–1369. doi: 10.1016/S0041-1345(98)02031-4. - DOI - PubMed
1. Mazzali M. Uric acid and transplantation. Semin. Nephrol. 2005;25:50–55. doi: 10.1016/j.semnephrol.2004.09.008. - DOI - PubMed
1. Ducloux D., Schuller V., Bresson-Vautrin C., Chalopin J.M. Colchicine myopathy in renal transplant recipients on cyclosporin. Nephrol. Dial. Transpl. 1997;12:2389–2392. doi: 10.1093/ndt/12.11.2389. - DOI - PubMed

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[1] Pichette V., Bonnardeaux A., Prudhomme L., Gagne M., Cardinal J., Ouimet D. Long-term bone loss in kidney transplant recipients: A cross-sectional and longitudinal study. Am. J. Kidney Dis. 1996;28:105–114. doi: 10.1016/S0272-6386(96)90138-9. - DOI - PubMed

[2] Pichette V., Bonnardeaux A., Prudhomme L., Gagne M., Cardinal J., Ouimet D. Long-term bone loss in kidney transplant recipients: A cross-sectional and longitudinal study. Am. J. Kidney Dis. 1996;28:105–114. doi: 10.1016/S0272-6386(96)90138-9. - DOI - PubMed

[3] Kart-Koseoglu H., Yucel A.E., Isiklar I., Turker I., Akcali Z., Haberal M. Joint pain and arthritis in renal transplant recipients and correlation with cyclosporine therapy. Rheumatol. Int. 2003;23:159–162. doi: 10.1007/s00296-002-0283-y. - DOI - PubMed

[4] Kart-Koseoglu H., Yucel A.E., Isiklar I., Turker I., Akcali Z., Haberal M. Joint pain and arthritis in renal transplant recipients and correlation with cyclosporine therapy. Rheumatol. Int. 2003;23:159–162. doi: 10.1007/s00296-002-0283-y. - DOI - PubMed

[5] Braun W.E., Richmond B.J., Protiva D.A., Gifford R.W., Jr., Straffon R.A. The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine. Transpl. Proc. 1999;31:1366–1369. doi: 10.1016/S0041-1345(98)02031-4. - DOI - PubMed

[6] Braun W.E., Richmond B.J., Protiva D.A., Gifford R.W., Jr., Straffon R.A. The incidence and management of osteoporosis, gout, and avascular necrosis in recipients of renal allografts functioning more than 20 years (level 5A) treated with prednisone and azathioprine. Transpl. Proc. 1999;31:1366–1369. doi: 10.1016/S0041-1345(98)02031-4. - DOI - PubMed

[7] Mazzali M. Uric acid and transplantation. Semin. Nephrol. 2005;25:50–55. doi: 10.1016/j.semnephrol.2004.09.008. - DOI - PubMed

[8] Mazzali M. Uric acid and transplantation. Semin. Nephrol. 2005;25:50–55. doi: 10.1016/j.semnephrol.2004.09.008. - DOI - PubMed

[9] Ducloux D., Schuller V., Bresson-Vautrin C., Chalopin J.M. Colchicine myopathy in renal transplant recipients on cyclosporin. Nephrol. Dial. Transpl. 1997;12:2389–2392. doi: 10.1093/ndt/12.11.2389. - DOI - PubMed

[10] Ducloux D., Schuller V., Bresson-Vautrin C., Chalopin J.M. Colchicine myopathy in renal transplant recipients on cyclosporin. Nephrol. Dial. Transpl. 1997;12:2389–2392. doi: 10.1093/ndt/12.11.2389. - DOI - PubMed

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

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