bisphosphonates associates with lower incidence of non-vertebral fractures after kidney transplantation. Methods: We conducted a retrospective review for all Southern California Kaiser Permanente kidney transplant recipients with osteoporosis transplanted between 2000 and 2019. Baseline variables were collected. Those prescribed an oral bisphosphonate were compared to those who were not. The primary outcome was non-vertebral fracture. Chi square was used to evaluate categorical variables and Wilcoxson rank sum test for continuous variables. Propensity scores were generated to balance covariates in the bisphosphonate and non-bisphosphonate groups. Cause-specific hazard and sub distribution (Fine-Gray) methods were performed for competing risk analysis. Death censored graft survival was evaluated as a secondary outcome using standard Cox regression. Results: There were 489 patients included in the study, 203 of which were in the bisphosphonate group. The cause specific hazard model suggested a 64% lower risk of non-vertebral fracture in the bisphosphonate group (p=0.02). The Fine-Gray hazard model treating death as a competing risk did not show lower relative incidence of non-vertebral fracture. Bisphosphonate treatment was associated with lower death censored graft failure (p=0.002). Conclusions: Bisphosphonate use after kidney transplantation may associate with lower risk of non-vertebral fracture after transplant. Bisphosphonate use in this study was also associated with lower death censored graft failure. Caution is advised when interpreting these results given the retrospective nature of the study. Copyright © 2024 by the American Society of Nephrology...

中文翻译：

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肾移植后使用双膦酸盐与较低的骨折风险相关


双膦酸盐与肾移植后非椎体骨折的发生率较低相关。方法： 我们对 2000 年至 2019 年间移植的所有南加州 Kaiser Permanente 骨质疏松症肾移植受者进行了回顾性评价。收集基线变量。将开具口服双膦酸盐的患者与未开具口服双膦酸盐的患者进行比较。主要结局是非椎体骨折。卡方用于评估分类变量，Wilcoxson 秩和检验用于连续变量。生成倾向评分以平衡双膦酸盐组和非双膦酸盐组的协变量。采用特定原因危害和子分布 （Fine-Gray） 方法进行竞争风险分析。使用标准 Cox 回归将死亡删失移植物存活率评估为次要结局。结果： 研究纳入 489 例患者，其中 203 例为双膦酸盐组。原因特异性风险模型表明，双膦酸盐组非椎体骨折的风险降低了 64% （p=0.02）。将死亡视为竞争风险的 Fine-Gray 风险模型并未显示非椎体骨折的相对发生率较低。双膦酸盐治疗与较低的死亡删失片段移植失败相关 （p=0.002）。结论： 肾移植后使用双膦酸盐可能与移植后非椎体骨折风险降低有关。本研究中使用双膦酸盐也与较低的死亡删失移植失败有关。鉴于该研究的回顾性，建议在解释这些结果时谨慎。美国肾脏病学会版权所有 © 2024...