TY - JOUR

T1 - Прогнозирование риска переломов у пациентов с трансплантатом почки

AU - Мазуренко, Сергей Олегович

AU - Семенова, Елена Валерьевна

AU - Мазуренко, Оксана Генриховна

AU - Накатис, Яков Александрович

AU - Гринев, Константин Михайлович

AU - Гурков, Александр Сергеевич

AU - Гомон, Юлия Михайловна

PY - 2022/2/18

Y1 - 2022/2/18

N2 - 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.

AB - 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.

KW - bone mineral density

KW - fractures

KW - kidney transplantation

KW - bone mineral density

KW - fractures

KW - kidney transplantation

UR - http://www.scopus.com/inward/record.url?scp=85126618057&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/4f0abb04-18b8-32d9-836a-50664b330672/

U2 - 10.36485/1561-6274-2022-26-1-44-49

DO - 10.36485/1561-6274-2022-26-1-44-49

M3 - статья

VL - 26

SP - 44

EP - 49

JO - Nephrology (Saint-Petersburg)

JF - Nephrology (Saint-Petersburg)

SN - 1561-6274

IS - 1

ER -