[Osteonecrosis in retransplated kidney patients resuming hemodialysis. Comparison with a hemodialysed population not having undergone transplantation. Discussion of the role and duration of corticotherapy as cause of aseptic osteonecrosis].

A systematic study in 5 hemodialysis centres was carried out for the incidence of aseptic osteonecrosis (AON) after two patients presented with this condition during hemodialysis after transplantation and rapid "retransplantation". The following observations were made after the assessment of similar cases and a comparison with a control population of hemodialysis patients not having undergone attempted renal transplantation. Ten patients had undergone "retransplantation". Four of these patients had one or more sites of AON. In 2 cases steroid therapy had been of short duration (29 and 43 days) but at massive doses. In the other two cases, steroid therapy had been prolonged for over one year. On the other hand, no cases of AON were found in the 156 patients not having undergone attempted transplantation on chronic hemodialysis therapy of known duration (p less than 0,00002). This study suggests that steroid therapy of very short duration may lead to irreversible early osteomedullary ischemia and to osteonecrosis. There was no significant difference in the duration of hemodialysis between the two groups of patients, with and without AON.