E-Poster 63rd Endocrine Society of Australia Annual Scientific Meeting 2020

Bone Health Among Indigenous Population Post Renal Transplant in Central Australia (#58)

Sin Dee Yap 1 2 , Audrey Khaing 1 , Basant Pawar 3 , Elna Ellis 1
  1. Department of Medicine, Alice Springs Hospital, The Gap, NT, Australia
  2. Department of Medicine, Monash Health, Clayton, VIC, Australia
  3. Department of Nephrology, Alice Springs Hospital, The Gap, NT, Australia

Objective: To assess the bone health of indigenous Australians who received renal transplant compared to non-indigenous Australians in Central Australia, between 2009 and 2019.

Background: 

A study shown that bone mineral density (BMD) in Aboriginal and/or Torres Strait Islander Australians is higher than Caucasian Australian reference ranges and these differences still remained significant in men after adjustment for lean mass, but there are few published BMD data in this population4.

In the general population, several studies have shown that biochemical abnormalities of bone minerals and metabolites improved following successful renal transplant. However, there are insufficient data describing bone health following transplantation among indigenous population.

Method: 

List of patients who received renal transplant between 2000 and 2019 in Alice Springs was collated. Baseline characteristic of patients were collected from hospital database. Serum bone turnover markers including total alkaline phosphatase (ALP), serum calcium, phosphate, Vitamin D and parathyroid hormone (PTH) levels and dual-energy bone densitometry (if applicable) were entered into Excel spreadsheet.

Results: 

31 patients received deceased organ after circulatory death (DCD) kidney transplant between 2009 and 2019. 24 patients were indigenous and 7 were non-indigenous. 

Baseline serum corrected calcium, phosphate, PTH levels were similar between the groups, except total ALP levels. Following renal transplant, the differences in serum corrected calcium, phosphate; PTH level changes were significant. 

The baseline bone density was not significant between the two groups. Following transplantation, the reduction in bone density at the hip was statistically significant in the indigenous group. The rate of bone loss did not differ between groups in both sites.

Conclusion: Baseline, post-transplant bone density at the lumbar spine and the rate of bone loss were similar between indigenous and non-indigenous patients who received renal transplant over 10 years in Central Australia. However, the changes in bone density at the hip were statistically significant.