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2021, Number 4

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Rev Nefrol Dial Traspl 2021; 41 (4)

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

León LR, Guardia OE, Angulo AU, Rivero AA, Suwezda A, Moya VL, Vega P, Walther J

Language: Spanish
References: 22
Page: 235-242
PDF size: 201.71 Kb.


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 nonvertebral 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 followup 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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