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NDT Advance Access originally published online on July 19, 2005
Nephrology Dialysis Transplantation 2005 20(10):2262-2264; doi:10.1093/ndt/gfh982
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Case Report

Bilateral femoral capital avascular necrosis in a renal transplant recipient on tacrolimus-based immunosuppression

L. Senthil Nayagam1, S. Govind Rajan1, Niranjan Khandelwal2, Ramesh Sen3, Harbir S. Kohli1, Kamal Sud1, Krishan L. Gupta1, Vinay Sakhuja1 and Vivekanand Jha1

Departments of 1 Nephrology, 2 Radiodiagnosis and 3 Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Correspondence and offprint requests to: Dr Vivekanand Jha, Additional Professor of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Email: vjha@pginephro.org

Keywords: avascular osteonecrosis; complications; kidney transplantation; prednisolone; tacrolimus

The first 150 words of the full text of this article appear below.



   Introduction
 
Avascular osteonecrosis (AVN) of the femoral head is one of the most common skeletal complications of kidney transplantation [1,2]. Factors governing its prevalence, risk factors and therapy remain controversial, even four decades after the initial description. It is generally accepted that corticosteroids play a crucial role in the pathogenesis. Prevalence of this complication decreased following the introduction of cyclosporin [1,3], but the effect of more recently introduced immunosuppressive agents is not so well documented. Here we report a 22-year-old patient who developed bilateral femoral head AVN 3.5 months after kidney transplantation, despite being on tacrolimus.



   Case
 
A 22-year-old male presented to our Institute for kidney transplantation in January 2004. He was first detected to have chronic kidney disease due to IgA nephropathy at another health facility in September 1999 and started on antihypertensives, phosphate binders, active vitamin D3 and iron. Prednisolone was given . . . [Full Text of this Article]



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