Nephrology · 2 h ago
Kidney transplant cohort finds delayed bone screening and higher fracture risk in older recipients
A nationwide Korean cohort study of 34,758 adult kidney transplant recipients assessed bone-density testing, medication continuity and fractures. Over a median 8.4 years, fracture incidence was highest among recipients aged 65 years or older, while fewer than one-third had bone mineral density testing in the first post-transplant year.
- Only 29.9% had BMD testing in the first post-transplant year.
- Fracture incidence was highest in recipients aged 65 or older.
- Prior fractures were linked to substantially higher post-transplant fracture risk.
Researchers used South Korea’s National Health Insurance Service database to study 34,758 adult kidney transplant recipients from 2003 to 2020. They assessed bone mineral density (BMD) testing, medication continuity and incident fractures by age group: younger than 50, 50–64, and 65 years or older. Median follow-up was 8.4 years.
Overall, 63.8% underwent BMD testing, but only 29.9% were tested during the first year after transplantation. Fracture incidence was 1.2 per 100 person-years overall and 3.9 per 100 person-years among recipients aged 65 or older. Compared with recipients younger than 50, the older group had higher adjusted fracture risks across post-transplant periods: adjusted subdistribution hazard ratios were 4.18 within the first year, 4.23 at 1–5 years, and 3.61 at five or more years. A pre-transplant fracture history was associated with a 5.2- to 7.6-fold increase in post-transplant fracture risk, but screening was not consistently intensified for younger recipients with such a history.
The findings point to delayed and uneven assessment of bone health after transplantation, particularly in people with risk factors. The observational study identifies gaps in screening patterns but does not establish that a particular screening or treatment strategy reduces fractures; the abstract provides no detailed results on medication continuity.
In practice
For clinicians caring for adult kidney transplant recipients, the cohort highlights that BMD assessment was often delayed and that older age and a pre-transplant fracture history identified groups with higher observed fracture risk. These findings may support attention to timely, risk-informed bone-health assessment, but they do not establish which screening schedule or treatment strategy prevents fractures. The evidence is observational and comes from a Korean national database, so it does not by itself justify a specific change in practice.
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Clinical Transplantation: Discordance Between Fracture Risk and Bone Health Management After Kidney Transplantation: A Nationwide Cohort Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.