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Predicting the risk of fractures in kidney transplant recipients

https://doi.org/10.36485/1561-6274-2022-26-1-44-49

Abstract

BACKGROUND. Chronic kidney disease leads to a significant increase in the risk of fractures, which increases even more after kidney transplantation.
THE AIM. The goal of this study was to develop simple, accessible criteria for predicting the risk of fracture in patients with a functioning kidney transplant.
PATIENTS AND METHODS. The prospective study included 131 kidney transplant recipients (men-55, women-76) (average age 39.7±11.7 years). The duration of follow-up was 40.7±21.2 months. Bone mineral density was assessed using dual-energy x-ray absorptiometry. To determine the prognostic significance of variables, we used stepwise regression (Cox model) analysis. p < 0.05 was considered statistically significant.
RESULTS. During the follow-up period, fractures were registered in 47 patients (35.9 %). Fractures were detected more often in women (42 %) than in men (27.3 %). All patients with fractures had lower bone mineral density and longer-term renal replacement therapy. Stepwise multivariate regression analysis showed that the combination of bone mineral density scores of lumbar vertebra and duration of renal replacement therapy best predicts the overall fracture risk. Adding the other variables to the analysis did not increase significantly their predictive value. A comparative analysis of the cumulative proportion of males and females with fractures confirmed a greater susceptibility of female transplant recipients to fractures.
CONCLUSIONS. The combination of bone mineral density scores of the lumbar vertebra with the duration of renal replacement therapy best predict the risk of fracture in patients with kidney transplants and can be used in the choice of prevention measures.

About the Authors

S. O. Mazurenko
Saint-Petersburg State University; North-Western district scientific and clinical center named after L.G. Sokolov
Russian Federation

Prof. Mazurenko Sergey Olegovich, MD, PhD, DMedSci; Department of Propaedeutics of Internal Diseases, Chief, Center for Osteoporosis and Metabolic Diseases of the Skeleton

194291, St. Petersburg, Kultury Street 4

Phone:+79117942845 



E. V. Semenova
I.I. Mechnikov North-Western Medical University
Russian Federation

Associate Professor Semenova Elena Valerievna, MD, PhD, Department of Internal Medicine, Clinical Pharmacology and Nephrology

195067, Saint Petersburg, Piskarevsky Ave. 47

Phone: +7-921-777-79-50 



O. G. Mazurenko
North-Western district scientific and clinical center named after L.G. Sokolov
Russian Federation

Mazurenko Oksana Genrihovna, MD, PhD Center for Osteoporosis and Metabolic Diseases of the Skeleton, radiologist

194291, St. Petersburg, Kultury Street 4

Phone: +79217552708 



Y. A. Nakatis
Saint-Petersburg State University; North-Western district scientific and clinical center named after L.G. Sokolov
Russian Federation

Prof. Nakatis Yakov Aleksandrovich, MD, PhD, DMedSci; Honorary President

194291, St. Petersburg, Kultury Street 4

Phone: +79219633149 



K. M. Grinev
Moscow Regional Research Clinical Institute named after M.F.Vladimirsky
Russian Federation

Grinev Konstantin Michalovich, MD, PhD, DMedSci Leningrad Regional Hospital, Surgeon

194291, St. Petersburg, Lunacharsky ave., 45 k.2, letter A

Phone: +79219481662 



A. S. Gurkov
Military Medical Academy named after S.M.Kirov
Russian Federation

Gurkov Alexander Sergeevich, MD, PhD, DMedSci; Surgeon of the Clinic of Nephrology and Dialysis

194044, Saint Petersburg, Akademika Lebedeva str. 37

Phone: +79119315512 



U. M. Gomon
Pavlov University
Russian Federation

Associate Professor Gomon Ulia Michailovna, MD, PhD, DMedSci; Department of Clinical Pharmacology and Evidence-Based Medicine

197022 Saint Petersburg Lva Tolstogo str., 6-8

Phone:++79119606268 



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For citations:


Mazurenko S.O., Semenova E.V., Mazurenko O.G., Nakatis Y.A., Grinev K.M., Gurkov A.S., Gomon U.M. Predicting the risk of fractures in kidney transplant recipients. Nephrology (Saint-Petersburg). 2022;26(1):44-49. (In Russ.) https://doi.org/10.36485/1561-6274-2022-26-1-44-49

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ISSN 1561-6274 (Print)
ISSN 2541-9439 (Online)