Mayuko Hori1, Kaoru Yasuda2, Hiroshi Takahashi3, Yutaka Matsuoka4, Makoto Tsujita2, Morikuni Nishihira5, Kazuharu Uchida4, Kunio Morozumi2, Shoichi Maruyama6. 1. Department of Nephrology, Masuko Memorial Hospital, 35-28 Takehashi-cho, Nakamura-ku, Nagoya, Aichi, 453-8566, Japan. m-hori@masuko.or.jp. 2. Department of Nephrology, Masuko Memorial Hospital, 35-28 Takehashi-cho, Nakamura-ku, Nagoya, Aichi, 453-8566, Japan. 3. Department of Nephrology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan. 4. Department of Renal Transplant Surgery, Masuko Memorial Hospital, Nakamura-ku, Nagoya, Aichi, Japan. 5. Department of Nephrology, Yuuai medical center, Tomishiro, Okinawa, Japan. 6. Department of Nephrology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Aichi, Japan.
Abstract
BACKGROUND: Although the prevalence of osteoporosis and fractures in the first 6-12 months post-renal transplantation is high, little is known about the utility of bone mineral density (BMD) to predict fractures in long-term kidney graft recipients. Lateral spine dual-energy X-ray absorptiometry (DXA) scanning is a reliable tool for measuring glucocorticoid-induced and age-related bone loss in the elderly population. However, little is known about the utility of lateral spine DXA for patients with chronic kidney diseases. This study aimed to analyze the utility of lateral spine BMD for fragility fractures in long-term kidney graft recipients. METHODS: A total of 357 stable kidney transplant recipients for a minimum of 1 year after kidney transplantation underwent DXA measurements at several sites, including the lateral spine between January 2017 and December 2018. We collected data on new incident fractures from the patients' medical records. RESULTS: The median post-transplantation time at baseline DXA measurement was 12.6 years. During the median follow-up period of 3.5 years, 41 (11.4%) fractures occurred. The lateral spine BMDs were independently associated with fractures (adjusted hazard ratio 0.076; 95% confidence interval 0.012-0.42, p = 0.003). The cumulative incidence rate of fractures was significantly higher in the lower lateral spine BMD group (< 0.471 g/cm2, optimal cut-off value by receiver operating characteristic curve) than in the higher lateral spine BMD group (23.4 vs. 7.4%, adjusted hazard ratio 4.92; 95% confidence interval 2.33-10.74, p < 0.001). CONCLUSION: Lateral lumbar spine BMD can be used to predict the risk of fragility fractures in long-term kidney graft recipients.
BACKGROUND: Although the prevalence of osteoporosis and fractures in the first 6-12 months post-renal transplantation is high, little is known about the utility of bone mineral density (BMD) to predict fractures in long-term kidney graft recipients. Lateral spine dual-energy X-ray absorptiometry (DXA) scanning is a reliable tool for measuring glucocorticoid-induced and age-related bone loss in the elderly population. However, little is known about the utility of lateral spine DXA for patients with chronic kidney diseases. This study aimed to analyze the utility of lateral spine BMD for fragility fractures in long-term kidney graft recipients. METHODS: A total of 357 stable kidney transplant recipients for a minimum of 1 year after kidney transplantation underwent DXA measurements at several sites, including the lateral spine between January 2017 and December 2018. We collected data on new incident fractures from the patients' medical records. RESULTS: The median post-transplantation time at baseline DXA measurement was 12.6 years. During the median follow-up period of 3.5 years, 41 (11.4%) fractures occurred. The lateral spine BMDs were independently associated with fractures (adjusted hazard ratio 0.076; 95% confidence interval 0.012-0.42, p = 0.003). The cumulative incidence rate of fractures was significantly higher in the lower lateral spine BMD group (< 0.471 g/cm2, optimal cut-off value by receiver operating characteristic curve) than in the higher lateral spine BMD group (23.4 vs. 7.4%, adjusted hazard ratio 4.92; 95% confidence interval 2.33-10.74, p < 0.001). CONCLUSION: Lateral lumbar spine BMD can be used to predict the risk of fragility fractures in long-term kidney graft recipients.
Authors: A M Alem; D J Sherrard; D L Gillen; N S Weiss; S A Beresford; S R Heckbert; C Wong; C Stehman-Breen Journal: Kidney Int Date: 2000-07 Impact factor: 10.612
Authors: J S Finkelstein; R L Cleary; J P Butler; R Antonelli; B H Mitlak; D J Deraska; J C Zamora-Quezada; R M Neer Journal: J Clin Endocrinol Metab Date: 1994-03 Impact factor: 5.958
Authors: Lucas E Nikkel; Christopher S Hollenbeak; Edward J Fox; Tadahiro Uemura; Nasrollah Ghahramani Journal: Transplantation Date: 2009-06-27 Impact factor: 4.939