Arnold Julia, Mytton Jemma, Evison Felicity, Gill Paramjit S, Cockwell Paul, Sharif Adnan, Ferro Charles J
From the Department of Nephrology, University Hospitals Birmingham NHS Foundation Trust and Department of Renal Medicine, University of Birmingham, United Kingdom.
Exp Clin Transplant. 2018 Aug;16(4):410-418. doi: 10.6002/ect.2017.0016. Epub 2017 Nov 15.
Fractures are associated with high morbidity and are a major concern for kidney transplant recipients. No comparative analysis has yet been conducted between countries in the contemporary era to inform future international prevention trials.
Data were obtained from the Hospital Episode Statistics and the Statewide Planning and Research Cooperative databases on all adult kidney transplants performed in England and New York State from 2003 to 2013, respectively, and on posttransplant fracture-related hospitalization from 2003 to 2014.
Our analysis included 18 493 English and 11 602 New York State kidney transplant recipients. Overall, 637 English recipients (3.4%) and 398 New York State recipients (3.4%) sustained a fracture, giving an unadjusted event rate of 7.0 and 5.9 per 1000 years, respectively (P = .948). Of these, 147 English (0.8%) and 101 New York State recipients (0.9%) sustained a hip fracture, giving an unadjusted event rate of 1.6 and 1.5 per 1000 years, respectively (P = .480). There were no differences in the cumulative incidence of all fractures or hip fractures. One-year mortality rates after any fracture (9% and 11%) or after a hip fracture (15% and 17%) were not different between cohorts.
Contemporaneous English and New York State kidney transplant recipients have similar fracture rates and mortality rates postfracture.
骨折与高发病率相关，是肾移植受者的主要担忧。当代尚未在各国之间进行比较分析，以指导未来的国际预防试验。
分别从医院事件统计数据和全州规划与研究合作数据库中获取2003年至2013年在英格兰和纽约州进行的所有成人肾移植数据，以及2003年至2014年移植后与骨折相关的住院数据。
我们的分析纳入了18493名英格兰肾移植受者和11602名纽约州肾移植受者。总体而言，637名英格兰受者（3.4%）和398名纽约州受者（3.4%）发生了骨折，未调整的事件发生率分别为每1000人年7.0次和5.9次（P = 0.948）。其中，147名英格兰受者（0.8%）和101名纽约州受者（0.9%）发生了髋部骨折，未调整的事件发生率分别为每1000人年1.6次和1.5次（P = 0.480）。所有骨折或髋部骨折的累积发生率没有差异。各队列中，任何骨折后（9%和11%）或髋部骨折后（15%和17%）的一年死亡率没有差异。
同期的英格兰和纽约州肾移植受者骨折率和骨折后死亡率相似。
