Background/Purpose: Osteoporosis in kidney transplant is complex and multifactorial. We studied the evolution of Trabecular Bone Score (TBS) and bone mineral density (BMD) in kidney transplant recipients as well as concurrent factors to their variations.

Methods: Transplant patients at Rouen University Hospital between August 2008 and January 2013 were selected. They must have received two bone densitometry exams measured by absportiometry dual-energy X-rays (DEXA). The TBS was calculated retrospectively.

Results: 66 patients were included. The change in the TBS was not significant between the two visits. The BMD increased significantly at three sites, lumbar spine + 3.3%, + 3.7% total hip, femoral neck + 2.2% (p <0.01). The duration of corticosteroid therapy was negatively correlated with the TBS (r = 0.41) and BMD at the lumbar spine (r = -0.52) (p <0.0001). Hyperparathyroidism or corticosteroid or chemotherapy induced diabetes was associated with poorest evolution of TBS (-0.046 95% CI [-0074, 0016] versus 0.031 95% CI [-0002, 0059], p= 0.02 and -0.048 95% CI [-0075, 0017] versus 0.038 95% CI [-0016, 0065], p <0.01) while the results on BMD were not significant. Regarding bisphosphonates, there was a positive correlation with BMD at the total hip (r= 0.33, p= 0.02).

Conclusion: TBS provides additional information with BMD in the osteoporotic risk assessment in transplant recipients, particularly in relation to glucocorticoid therapy, hyperparathyroidism and diabetes.