Risk factors for nonvertebral bone fractures in kidney transplant recipients: a complex reality?

  • Luis Roberto León Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Olga Elena Guardia Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Ana Uriona Angulo Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Anelisse Rivero Arauz Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Alejandro Suwezda Cátedra de Bioestadística, Universidad del Salvador (USAL), Buenos Aires, Argentina
  • Lidia Moya Vidal Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Patricia Vega Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
  • Javier Walther Instituto de Trasplantes y Alta Complejidad (ITAC) - Diaverum, Buenos Aires, Argentina
Keywords: renal transplant, morbidity and mortality, risk factors, non-vertebral bone fractures

Abstract

Introduction: Fractures in renal postransplantation represent one of the complications that increase morbidity and mortality in patients. Objective: To determine the risk factors for transplantation of non-vertebral fractures in renal transplant recipients. Methods: The data of clinical histories of 737 renal transplanted patients since 2009-2015 were analyzed, where the risk factors of fractures were evaluated. They were determined as general factors: age, sex; and specific factors: etiology of chronic kidney disease (ERC), dialysis time, dialysis modality, donor characteristics: age, sex, type of donor, living or cadaveric (DV, DC), different immunosuppression treatments, rejections, treatment with steroid pulses, use of bisphosphonates and biochemical parameters like intact parathormone (PTHI), Pro -Vitamin D (25OHD) and Creatininemia (CREATS). Exclusion criteria: patients <18 years, retransplantation or double transplants and follow-up less than 1 year. Results: 44 patients presented 50 non-vertebral fractures. 62% of the fractures were presented in the first 3 years of the transplant. In the multivariate model it was observed that the general risk factors associated with fracture risk were the advanced age of the receptor (aHR per year increases 1.03, 95% CI: 1.00-1.05] and the female sex (aHR = 1.60, 95% CI: 0.85-2.99), while the specific risk factors were dialysis time (1.07 IC95%: 1.02-1.12), the higher age of the donor (1.03 IC95: 1,00-1,05) and the deficit of 25OHD (3.17 IC95: 1.57-6.41). Conclusions: This study allowed to evaluate predictive factors of fracture in our patients with kidney transplantation.

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Published
2021-12-02
How to Cite
1.
León LR, Guardia OE, Uriona Angulo A, Rivero Arauz A, Suwezda A, Moya Vidal L, Vega P, Walther J. Risk factors for nonvertebral bone fractures in kidney transplant recipients: a complex reality?. Rev Nefrol Dial Traspl. [Internet]. 2021Dec.2 [cited 2024Jul.27];41(4):235-42. Available from: http://revistarenal.org.ar/index.php/rndt/article/view/707
Issue
Vol. 41 No. 4 (2021): Oct. - Dic.
Section
Original Article

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