Risk factors for fracture in adult kidney transplant recipients

Table 1 Characteristics of kidney transplant recipients classified by major fracture status¹n (%)

	No fracture (n = 2591)	Major Fracture (n = 132)	P-value
General risk factors
Age (yr)	50.5 (41-61)	56.5 (45-63)	0.01
Women	928 (35.8)	66 (48.5)	0.004
Race/ethnicity			0.40
White	1845 (71.2)	103 (78)
Asian	208 (8.0)	8 (6.1)
Black	198 (7.6)	7 (5.3)
Other2	340 (13.1)	14 (10.6)
Diabetes	673 (25.6)	40 (30.3)	0.27
Fall with hospitalization in the year prior to the transplant date	92 (3.6)	8 (6.1)	0.15
Major fracture prior to the transplant date3
Transplant specific risk factors
Length of time on dialysis prior to transplant (measured in years)4	2.8 (1.2-5.4)	2.7 (0.92-5.1)	0.56
Type of donor			0.47
Deceased (vs living)	1458 (56.3)	70 (53.0)
Cause of end-stage renal disease5			0.004
Glomerulonephritis	951 (36.7)	39 (29.6)
Cystic kidney disease	385 (14.9)	31 (23.5)
Diabetes	560 (21.6)	37 (28.0)
Other	695 (26.8)	25 (18.9)
Pre-transplant dialysis modality6			0.99
Peritoneal dialysis	701 (27.1)	35 (26.5)
Hemodialysis	1622 (62.6)	83 (62.9)
Pre-emptive	268 (10.3)	14 (11.6)
Donor characteristics
Type of donor			0.47
Deceased (vs living)	1458 (56.3)	70 (53.0)
Donor age (yr)	46 (36-54)	48 (41-55)	0.16
Donor sex			0.73
Women	1295 (50.0)	68 (51.5)

Data are median (interquartile range) or n (%). ¹Major fracture events were comprised of forearm (n = 81), hip (n = 22), proximal humerus (n = 18), and clinical vertebral fractures (n = 13);

²Other was defined as a composite of: Indian Sub-Continent, Pacific Islander, Aboriginal, Mid East/Arabian, Latin American, Other/Multiracial;

³Due to the small number of recipients with a prior major fracture this risk factor was not able to be assessed;

⁴Includes individuals who received a pre-emptive transplant where the time spent on dialysis was defined as 0 years;

⁵Due to the small number of recipients with a major fracture who had renal vascular disease as the cause of their ESRD this category was combined into the other category;

⁶We defined hemodialysis and peritoneal dialysis based on the modality the recipient first received. We defined pre-emptive transplant as no evidence of hemodialysis or peritoneal dialysis prior to transplant. ESRD: End-stage renal disease.