Radiofrequency Echographic Multi-Spectrometry (REMS) technology and DXA for BMD assessment in kidney transplant recipients

Introduction: Radiofrequency Echographic Multi-Spectrometry (REMS) is a novel ultrasound-based technique that has shown good reliability in the assessment of BMD in women affected by post-menopausal osteoporosis. Data on special populations with secondary osteoporosis are needed.

Objectives: The aim of this study was to compare the performance of the REMS BMD assessment with DXA in a cohort of kidney transplant recipients (KTR).

Methods: Consecutive patients referring to our KTR clinic were enrolled. All subjects fulfilled the following inclusion criteria: Caucasian population, both genders, age between 40 and 80 years, BMI < 40kg/m2. The enrolled patients underwent a lumbar spine (LS) and femoral neck (FN) examination with DXA and REMS. Differences in DXA vs REMS T-scores were analyzed through Student’s t test for independent samples, correlations were tested though Pearson’s correlation. Differences in prevalence were tested trough Chi-squared test. Written informed consent was obtained from all participants (protocol 1483CESC).

Results: 40 patients were enrolled (table 1). At the LS, BMD was significantly lower when assessed through REMS. The correlation between the T-scores obtained with DXA and REMS are depicted in figure 1. When adopting the worst site, the prevalence of subjects with T-score <-2.5 was 40.5% with DXA and 37.8% with REMS (p=NS) and of subjects with T-score <-1 was 89% with DXA and 97.5% with REMS (p=0.003).

Conclusions: These results showed a good reliability of the REMS technology with respect to DXA in the classification of KTR patients as having low bone mass and/or osteoporosis. Furthermore, REMS might be more sensitive than DXA in the detection of early bone impairment and in the classification of KTR patients with low bone mass.