Time-Varying Risk Factors for Incident Fractures in Kidney Transplant Recipients: A Nationwide Cohort Study in South Koreaopen access
- Authors
- Eum, Sang Hun; Kim, Da Won; Lee, Jeong-Hoon; Jeon, Jin Seok; Jun, Heungman; Yang, Jaeseok; Kim, Myoung Soo; Yoon, Hye Eun; Jung, Cheol Woong
- Issue Date
- Mar-2023
- Publisher
- MDPI AG
- Keywords
- CKD-MBD; fracture; kidney transplantation; bone disease; immunosuppression
- Citation
- Journal of Clinical Medicine, v.12, no.6
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Clinical Medicine
- Volume
- 12
- Number
- 6
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62926
- DOI
- 10.3390/jcm12062337
- ISSN
- 2077-0383
- Abstract
- Little is known about the time-varying risk factors for fractures in kidney transplant recipients (KTRs). Using the Korea Organ Transplantation Registry, a nationwide cohort study of KTRs, the incidence, locations, and time-varying predictors of fractures were analyzed, including at baseline and post-transplant 6-month variables in KTRs who underwent KT between January 2014 and June 2019. Among 4134 KTRs, with a median follow-up of 2.94 years (12,441.04 person-years), 63 patients developed fractures. The cumulative 5-year incidence was 2.10%. The most frequent locations were leg (25.40%) and foot/ankle (22.22%). In multivariable analysis, older recipient age at baseline (hazard ratio [HR], 1.035; 95% confidence interval [CI], 1.007-1.064; p = 0.013) and higher tacrolimus trough level (HR, 1.112; 95% CI, 1.029-1.202; p = 0.029) were associated with higher risks for fractures. Pretransplant diabetes mellitus had a time-dependent impact on fractures, with increasing risk as time elapses (HR for diabetes mellitus 1.115; 95% CI, 0.439-2.832; HR for diabetes mellitus x time, 1.049; 95% CI, 1.007-1.094; p = 0.022). In conclusion, KTRs had a high risk of peripheral skeletal fractures in the first 5 years. At baseline recipient age, pretransplant diabetes mellitus and tacrolimus trough level after KT were responsible for the fractures in KTRs.
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Collections - 2. Clinical Science > Department of Transplantation and Vascular Surgery > 1. Journal Articles
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