ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2004
Long-term fracture risk following renal transplantation: a population-based study.
Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.
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Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it, 182 citations in OpenAlex.
- Efficacy and Safety of Bisphosphonates for Low Bone Mineral Density After Kidney Transplantation: A Meta-Analysis.Medicine · 2016Pooled it
- Marine n-3 Polyunsaturated Fatty Acids and Bone Mineral Density in Kidney Transplant Recipients: A Randomized, Placebo-Controlled Trial.Nutrients · 2021Trial
- Change in bone mineral density at one year following glucocorticoid withdrawal in kidney transplant recipients.Clinical transplantationTrial
- Mineral and Bone Disease in CKD and Kidney Transplantation: Controversies, Gaps, and a Path Forward.Kidney international reports · 2026Review
- Awareness of post-transplant endocrine disorders among kidney transplant clinicians: results of an Italian survey.Journal of endocrinological investigation · 2026Article
- Efficacy and safety of teriparatide in kidney transplant recipients with osteoporosis and low bone turnover: a real-world experience.International urology and nephrology · 2025Observational
- Dual-Energy X-Ray Absorptiometry-Derived Advanced Hip Analysis and the Trabecular Bone Score Are Associated With the Diagnosis of Fracture Following Kidney and Simultaneous Pancreas-Kidney Transplantation.Clinical transplantation · 2025Article
- Impact of corticosteroid withdrawal on bone mineral density after kidney transplantation.Aging clinical and experimental research · 2025Article
- Vertebral fractures in patients with CKD and the general population: a call for diagnosis and action.Clinical kidney journal · 2024Review
- Bone Loss after Solid Organ Transplantation: A Review of Organ-Specific Considerations.Endocrinology and metabolism (Seoul, Korea) · 2024Review
- Post-Transplant Bone Disease in Kidney Transplant Recipients: Diagnosis and Management.International journal of molecular sciences · 2024Review
- Time-Varying Risk Factors for Incident Fractures in Kidney Transplant Recipients: A Nationwide Cohort Study in South Korea.Journal of clinical medicine · 2023Article
- Clinical predictors of incipient vertebral fractures and bone mineral density in kidney transplant patients.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Kidney Transplantation, Immunosuppression and the Risk of Fracture: Clinical and Economic Implications.Kidney medicine · 2022Article
- Clinical Prediction of High-Turnover Bone Disease After Kidney Transplantation.Calcified tissue international · 2022Article
- The Role of Alterations in Alpha-Klotho and FGF-23 in Kidney Transplantation and Kidney Donation.Frontiers in medicine · 2022Review
- Factors Related to Bone Metabolism in Kidney Transplant Recipients.Mediators of inflammation · 2021Article
- Risk Factors and Management of Osteoporosis Post-Transplant.Medicina (Kaunas, Lithuania) · 2020Review
- Early steroid withdrawal has a positive effect on bone in kidney transplant recipients: a propensity score study with inverse probability-of-treatment weighting.Therapeutic advances in musculoskeletal disease · 2020Article
- Glucocorticoid-Induced Osteoporosis: Why Kids Are Different.Frontiers in endocrinology · 2020Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
Abnormal bone metabolism is a recognized complication of end-stage renal disease, but fracture risk following renal transplantation has not been well quantified. We followed the 86 Olmsted County, Minnesota, residents who underwent initial renal transplantation in 1965-1995 for 911 person-years (median, 10.6 years per subject) in a retrospective cohort study. Fractures, and possible risk factors, were assessed through review of each subject's complete community medical records. Altogether, 117 fractures were observed during follow-up extending to 33 years. The cumulative incidence of any fracture at 15 years was 60% versus 20% expected ( P<0.001). There was a significantly increased risk of fractures generally [standardized incidence ratio (SIR), 4.8; 95% CI, 3.6-6.4] and vertebral (SIR, 23.1; 95% CI, 12.3-39.6) and foot fractures (SIR, 8.4; 95% CI, 5.1-12.9) especially. Age at first transplantation, renal failure due to diabetes, pancreas transplantation, peripheral neuropathy, peripheral vascular disease and blindness were all associated with overall fracture risk. In a multivariate analysis, however, only age and diabetic nephropathy were independent predictors of fracture risk generally, while higher activity status was protective. Diabetes was the only independent predictor of lower limb fractures, whereas age and osteoporosis history predicted vertebral fractures. Cumulative corticosteroid dosage was not associated with increased fracture risk in this analysis. Despite the fact that our patients had few risk factors for preexisting bone disease attendant to postmenopausal osteoporosis, prior corticosteroid use or renal osteodystrophy, these data indicate that renal transplantation is associated with a significant increase in fracture risk among unselected patients in the community. Diabetic patients, particularly, experience excess lower limb fractures. Patients and their care providers should be aware of this elevated fracture risk, which continues long-term.
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Registered trials
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