Introduction
Methods
Study cohort
Identification of PTX, comorbidity and fractures
Exclusions
Matching
Statistical analyses
Results
Demographics and patient characteristics
Factor | Whole cohort (n = 20,011) | Matched PTX and non-PTX patients (n = 2549) | |
---|---|---|---|
PTX (n = 579) | Non-PTX (n = 1970) | ||
Age (years) at start in RRT |
62.8 (16.5)
|
50.1 (14.3)
|
50.4 (14.3)
|
Age at PTX (or corresponding date for non-PTX patients = t) | – |
54.1 (13.6)
|
54.0 (13.7)
|
Sex | |||
Female | 7131 (35.6) | 297 (51.3) | 975 (49.5) |
Male | 12,880 (64.4) | 282 (48.7) | 995 (50.5) |
Time on RRT at PTX (t) (years) | – |
4.0 (3.2) |
3.5 (3.4) |
Cause of ESRD | |||
ADPKD | 1572 (7.9) | 84 (14.5) | 293 (14.9) |
Diabetes mellitus | 4843 (24.2) | 89 (15.4) | 317 (16.1) |
Glomerulonephritis | 3182 (15.9) | 179 (30.9) | 642 (32.6) |
Nephrosclerosis | 3651 (18.2) | 57 (9.8) | 175 (8.9) |
Pyelonephritis | 1009 (5.0) | 48 (8.3) | 118 (6.0) |
Other and unknown | 5754 (28.8) | 122 (21.1) | 425 (21.5) |
Number of transplantations | |||
0 | 14,951 (74.7) | 214 (37.0) | 752 (38.2) |
1 | 4686 (23.5) | 298 (51.4) | 1096 (55.6) |
2 | 347 (1.7) | 58 (10.0) | 114 (5.8) |
3 | 23 (0.1) | 8 (1.4) | 7 (0.3) |
4 | 4 (<0.1) | 1 (0.2) | 1 (0.1) |
Functioning allograft at PTX (t) | – | 156 (27.0) | 736 (37.3) |
Charlson comorbidity score at PTX (t) | – |
1.2 (1.6)
|
1.4 (1.8)
|
Hip fracture before PTX (t) | – | 22 (4.0) | 57 (3.0) |
Fracture incidence
Factor | Whole cohort | Matched PTX and non-PTX patients | ||||
---|---|---|---|---|---|---|
PTX | No PTX | |||||
n (%) | Incidence rate |
n (%) | Incidence rate |
n (%) | Incidence rate | |
All | 20,011 (100) | 11.0 (10.3–11.8) | 579 (100) | 4.1 (2.7–6.2) | 1970 (100) | 6.1 (5.0–7.4) |
Male | 12,880 (64) | 9.3 (8.5–10.2) | 282 (49) | 4.5 (2.5–7.9) | 995 (51) | 4.4 (3.2–6.1) |
Female | 7131 (36) | 14.1 (12.8–15.6) | 297 (51) | 3.7 (2.0–7.0) | 975 (49) | 7.8 (6.1–10.0) |
Age at start of RRT | ||||||
<55 | 5481 (27) | 3.8 (3.2–4.5) | 350 (60) | 3.0 (1.7–5.4) | 1181 (60) | 3.6 (2.6–4.8) |
55–65 | 3788 (19) | 10.0 (8.6–11.7) | 139 (24) | 2.6 (0.8–8.0) | 499 (25) | 7.9 (5.5–11.5) |
65–75 | 5432 (27) | 19.1 (17.0–21.5) | 75 (13) | 15.5 (7.4–32.6) | 216 (11) | 18.5 (12.0–28.3) |
>75 | 5310 (27) | 30.1 (26.8–33.8) | 15 (3) | 14.8 (2.1–105.3) | 74 (4) | 35.7 (19.2–66.3) |
PTX | 676 (4) | 4.7 (3.2–6.7) | – | – | – | – |
No PTX | 19,335 (96) | 11.6 (10.8–12.4) | – | – | – | – |
No renal transplantation at any time during observation | 14,951 (75) | 20.7 (19.2–22.2) | 214 (37) | 11.6 (7.0–19.2) | 752 (38) | 14.1 (10.8–18.5) |
Renal transplantation during observation | 5060 (25) | 3.5 (3.0–4.1) | 365 (63) | 1.7 (0.8–3.6) | 1218 (62) | 3.7 (2.7–4.9) |
Effect of PTX on risk of fracture
Factor | All (n = 2549) | ||
---|---|---|---|
Crude | Adjusted | ||
PTX | No | Ref | Ref |
Yes | 0.61 (0.31–1.18) | 0.40 (0.18–0.88) | |
Charlson index score | 0.97 (0.80–1.18) | 0.94 (0.76–1.16) | |
Hip fracture before t
| No | Ref | Ref |
Yes | 4.86 (1.74–13.59) | 5.05 (1.57–16.23) | |
Cum. time in RRT before PTX | 0–2 years | Ref | Ref |
2–4 years | 1.51 (0.69–3.30) | 1.32 (0.57–3.06) | |
>4 years | 2.33 (1.05–5.14) | 2.40 (0.92–6.21) | |
Cum. time with graft before PTX | None | Ref | Ref |
1–3 years | 3.31 (0.55–20.12) | 5.28 (0.68–40.75) | |
>3 years | 3.05 (0.44–21.13) | 2.73 (0.28–26.79) | |
Cum. time with graft after PTX | None | Ref | Ref |
1–4 years | 0.81 (0.25–2.56) | 0.88 (0.26–3.04) | |
>4 years | 0.19 (0.06–0.66) | 0.19 (0.05–0.70) |