Risk Factors for First and Recurrent Fractures among Kidney Transplant Recipients.
Norman Atagu, Stefani Mihilli, Huong Thao Nguyen and 4 others
PMID 36514897WHAT IT FOUND
Kidney transplant recipients face high fracture rates, with 27% breaking a bone within 10 years.
Female sex, diabetes, and prior fracture increase first-fracture risk. For recurrent fractures, female sex, diabetes, and recent transplant era are key risks, while higher BMI appears protective.
Key findings
01The 10-year cumulative incidence of any first fracture was 27.1%, and for major osteoporotic fractures it was 17.8%.
02Female recipient sex, history of pretransplant fracture, and recipient history of diabetes were independent risk factors for any first fracture.
03For recurrent fractures, female recipient sex, history of diabetes, and receiving a transplant in the 2011-2013 era were associated with increased risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
Single-center study in Ontario, Canada, which may limit generalizability to other populations. Fracture dates were uncertain for 25% of cases, potentially affecting incidence estimates. Data on glucocorticoid use, bone mineral density, and anti-resorptive therapy were not available, so their confounding effects cannot be ruled out. The study did not analyze the impact of fractures on patient outcomes like mortality or quality of life.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not assume that a history of pretransplant fracture predicts recurrent fractures in this population. The study found that while prior fracture increased the risk of a first posttransplant fracture, it did not persist as a significant risk factor for recurrent fractures.