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NDT Advance Access published online on September 12, 2006
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfl400
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received December 27, 2005
Accepted June 13, 2006

Original Article

Thrombophilia and avascular necrosis of femoral head in kidney allograft recipients

Yakup Ekmekci 1, Kenan Keven 1 *, Nejat Akar 2, Yonca Egin 2, Sule Sengul 1, Sim Kutlay 1, Sehsuvar Erturk 1, and Bulent Erbay 1

1 Department of Nephrology, Ankara University School of Medicine, Ankara, Turkey
2 Department of Pediatric Molecular Genetic, Ankara University School of Medicine, Ankara, Turkey

* To whom correspondence should be addressed.
Kenan Keven, E-mail: keven{at}medicine.ankara.edu.tr



  Abstract

Background. Thrombophilia has been implicated in the development of avascular necrosis (AVN) in various diseases. We aimed to search for the relation of both prothrombin gene G20210A mutation and factor V G1691A (factor V Leiden) mutation with AVN among kidney transplant recipients.

Methods. Nineteen patients with AVN and 38 control patients without AVN were included. Clinical information was collected, and gender, age, type of renal allograft, duration and type of dialysis, presence of acute rejection, and cumulative doses of ciclosporin and corticosteroid administration were taken into consideration. Genotypes of factor V G1691A and prothrombin G20210A were determined by direct sequencing of genomic DNA.

Results. Factor V Leiden mutation was detected in six patients (31.6%) among patients with AVN and in only three patients (7.9%) in the control group (P = 0.048). Two patients (10.5%) in the AVN group were determined to have prothrombin G20210A mutation, while no prothrombin G20210A mutation was detected in the control group. When both of the mutations causing thrombophilia were considered, a total of eight patients (42.1%) in the AVN group and three patients (7.9%) in the control group were identified (P = 0.004).

Conclusion. Thrombophilia seems to be an important risk factor for development of AVN. More studies are needed to clarify the role of factor V G1691A and prothrombin G20210A mutation for AVN.

Keywords: avascular necrosis; factor V Leiden; kidney transplantation; prothrombin G20210A; thrombophilia.
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