Pretransplant Osteoporosis and Osteopenia are Risk Factors for Fractures After Kidney Transplantation

KNOW-KT Study Group

Research output: Contribution to journalArticle

Abstract

Background: There is a high risk of fracture after kidney transplantation (KT). Recipients of KT are susceptible to persistent hyperparathyroidism and other disorders of bone and mineral metabolism. However, the risk factors for fractures after KT remain uncertain. The aim of the present study was to investigate the risk factors for fracture after KT. Methods: A total of 941 recipients of KT were enrolled from a multicenter observational cohort study in Korea from 2012 to 2016. The biochemical markers were measured at the time of KT, then annually for 5 years following KT. All fracture events were recorded. A Cox proportional hazards analysis was performed to calculate hazard ratios (HR) for the association of risk factors with fractures. Results: Twenty-two fractures had occurred in 20 patients during the study period. Baseline and serial changes of mineral and bone biochemical markers were similar between fracture and nonfracture patient groups. Among the total study population, 104 patients were diagnosed with osteoporosis and 422 patients were diagnosed with osteopenia in a pretransplant bone mineral density test. In a multivariate Cox analysis, pretransplant osteoporosis (HR = 11.76; 95% confidence interval [CI], 2.28-60.69; P =.003) and pretransplant osteopenia (HR = 5.21; 95% CI, 1.15-23.57; P =.032) were independent risk factors for fracture in recipients of KT. Conclusions: Pretransplant osteoporosis and osteopenia were independent risk factors for fracture after KT. More careful monitoring of bone mineral density before and after KT might be beneficial to predict the risk for fracture after KT.

Original languageEnglish
JournalTransplantation Proceedings
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Metabolic Bone Diseases
Kidney Transplantation
Osteoporosis
Bone Density
Minerals
Biomarkers
Confidence Intervals
Bone and Bones
Hyperparathyroidism
Korea
Observational Studies
Cohort Studies
Multivariate Analysis

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Pretransplant Osteoporosis and Osteopenia are Risk Factors for Fractures After Kidney Transplantation. / KNOW-KT Study Group.

In: Transplantation Proceedings, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Pretransplant Osteoporosis and Osteopenia are Risk Factors for Fractures After Kidney Transplantation",
abstract = "Background: There is a high risk of fracture after kidney transplantation (KT). Recipients of KT are susceptible to persistent hyperparathyroidism and other disorders of bone and mineral metabolism. However, the risk factors for fractures after KT remain uncertain. The aim of the present study was to investigate the risk factors for fracture after KT. Methods: A total of 941 recipients of KT were enrolled from a multicenter observational cohort study in Korea from 2012 to 2016. The biochemical markers were measured at the time of KT, then annually for 5 years following KT. All fracture events were recorded. A Cox proportional hazards analysis was performed to calculate hazard ratios (HR) for the association of risk factors with fractures. Results: Twenty-two fractures had occurred in 20 patients during the study period. Baseline and serial changes of mineral and bone biochemical markers were similar between fracture and nonfracture patient groups. Among the total study population, 104 patients were diagnosed with osteoporosis and 422 patients were diagnosed with osteopenia in a pretransplant bone mineral density test. In a multivariate Cox analysis, pretransplant osteoporosis (HR = 11.76; 95{\%} confidence interval [CI], 2.28-60.69; P =.003) and pretransplant osteopenia (HR = 5.21; 95{\%} CI, 1.15-23.57; P =.032) were independent risk factors for fracture in recipients of KT. Conclusions: Pretransplant osteoporosis and osteopenia were independent risk factors for fracture after KT. More careful monitoring of bone mineral density before and after KT might be beneficial to predict the risk for fracture after KT.",
author = "{KNOW-KT Study Group} and Lee, {Eun Song} and Lim, {Jeong Hoon} and Cho, {Jang Hee} and Jung, {Hee Yeon} and Choi, {Ji Young} and Park, {Sun Hee} and Kim, {Yong Lim} and Han Ro and Sik Lee and Han, {Seung Yeup} and Jung, {Cheol Woong} and Park, {Jae Berm} and Kim, {Myoung Soo} and Jaeseok Yang and Curie Ahn and Kim, {Chan Duck}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.transproceed.2019.03.071",
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T1 - Pretransplant Osteoporosis and Osteopenia are Risk Factors for Fractures After Kidney Transplantation

AU - KNOW-KT Study Group

AU - Lee, Eun Song

AU - Lim, Jeong Hoon

AU - Cho, Jang Hee

AU - Jung, Hee Yeon

AU - Choi, Ji Young

AU - Park, Sun Hee

AU - Kim, Yong Lim

AU - Ro, Han

AU - Lee, Sik

AU - Han, Seung Yeup

AU - Jung, Cheol Woong

AU - Park, Jae Berm

AU - Kim, Myoung Soo

AU - Yang, Jaeseok

AU - Ahn, Curie

AU - Kim, Chan Duck

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: There is a high risk of fracture after kidney transplantation (KT). Recipients of KT are susceptible to persistent hyperparathyroidism and other disorders of bone and mineral metabolism. However, the risk factors for fractures after KT remain uncertain. The aim of the present study was to investigate the risk factors for fracture after KT. Methods: A total of 941 recipients of KT were enrolled from a multicenter observational cohort study in Korea from 2012 to 2016. The biochemical markers were measured at the time of KT, then annually for 5 years following KT. All fracture events were recorded. A Cox proportional hazards analysis was performed to calculate hazard ratios (HR) for the association of risk factors with fractures. Results: Twenty-two fractures had occurred in 20 patients during the study period. Baseline and serial changes of mineral and bone biochemical markers were similar between fracture and nonfracture patient groups. Among the total study population, 104 patients were diagnosed with osteoporosis and 422 patients were diagnosed with osteopenia in a pretransplant bone mineral density test. In a multivariate Cox analysis, pretransplant osteoporosis (HR = 11.76; 95% confidence interval [CI], 2.28-60.69; P =.003) and pretransplant osteopenia (HR = 5.21; 95% CI, 1.15-23.57; P =.032) were independent risk factors for fracture in recipients of KT. Conclusions: Pretransplant osteoporosis and osteopenia were independent risk factors for fracture after KT. More careful monitoring of bone mineral density before and after KT might be beneficial to predict the risk for fracture after KT.

AB - Background: There is a high risk of fracture after kidney transplantation (KT). Recipients of KT are susceptible to persistent hyperparathyroidism and other disorders of bone and mineral metabolism. However, the risk factors for fractures after KT remain uncertain. The aim of the present study was to investigate the risk factors for fracture after KT. Methods: A total of 941 recipients of KT were enrolled from a multicenter observational cohort study in Korea from 2012 to 2016. The biochemical markers were measured at the time of KT, then annually for 5 years following KT. All fracture events were recorded. A Cox proportional hazards analysis was performed to calculate hazard ratios (HR) for the association of risk factors with fractures. Results: Twenty-two fractures had occurred in 20 patients during the study period. Baseline and serial changes of mineral and bone biochemical markers were similar between fracture and nonfracture patient groups. Among the total study population, 104 patients were diagnosed with osteoporosis and 422 patients were diagnosed with osteopenia in a pretransplant bone mineral density test. In a multivariate Cox analysis, pretransplant osteoporosis (HR = 11.76; 95% confidence interval [CI], 2.28-60.69; P =.003) and pretransplant osteopenia (HR = 5.21; 95% CI, 1.15-23.57; P =.032) were independent risk factors for fracture in recipients of KT. Conclusions: Pretransplant osteoporosis and osteopenia were independent risk factors for fracture after KT. More careful monitoring of bone mineral density before and after KT might be beneficial to predict the risk for fracture after KT.

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U2 - 10.1016/j.transproceed.2019.03.071

DO - 10.1016/j.transproceed.2019.03.071

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C2 - 31477421

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JO - Transplantation Proceedings

JF - Transplantation Proceedings

SN - 0041-1345

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