Can DXA Predict Fractures in Renal Transplant Patients?
Article first published online: 6 OCT 2008
© 2008 The Authors Journal compilation © 2008 The American Society of Transplantation and the American Society of Transplant Surgeons
American Journal of Transplantation
Volume 8, Issue 12, pages 2647–2651, December 2008
How to Cite
Akaberi, S., Simonsen, O., Lindergård, B. and Nyberg, G. (2008), Can DXA Predict Fractures in Renal Transplant Patients?. American Journal of Transplantation, 8: 2647–2651. doi: 10.1111/j.1600-6143.2008.02423.x
- Issue published online: 11 NOV 2008
- Article first published online: 6 OCT 2008
- Received 08 April 2008, revised 26 June 2008 and accepted for publication 29 June 2008
- Bone mineral density;
- diabetes mellitus;
- renal allograft
Renal transplant patients have a high prevalence of osteopenia, osteoporosis and fractures. The aim of the study was to investigate whether dual-energy x-ray absorptiometry (DXA) is of value to predict fractures. In 1995–2007, 238 renal transplant patients underwent 670 DXA investigations. Osteopenia (46.0%), osteoporosis (13.9%) and absolute bone mineral density (BMD) (median 0.9, range 0.4–2.0 g/cm2) in the hip region were used to evaluate fracture risk. Data on fractures were collected at the occasion of each DXA, and a questionnaire was filled in by 191 patients at regular outpatient visits. Reported fractures were verified by consultation of medical records. In all, 46 patients had 53 fractures. Cumulative hazard of fracture was significantly different among normal BMD, osteopenia and osteoporosis in the hip (p < 0.0001). A Cox proportional hazard analysis also including age, gender and diabetic nephropathy showed significantly increased fracture risk for osteoporosis (3.5 times, CI 1.8–6.4, p = 0.0001) as well as for osteopenia (2.7 times, 1.6–4.6, p = 0.0003). A significantly increased risk was also found with absolute BMD estimates below the median. Osteopenia and an absolute bone density below 0.9 g/cm2 in the hip region confer an increased risk of fracture.