Discordance Between Fracture Risk and Bone Health Management After Kidney Transplantation: A Nationwide Cohort Study.
- 1Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea.
- 2Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea.
- 3Biomedical Research Center, Korea University Guro Hospital, Seoul, South Korea.
Abstract
Background
Bone loss and fractures are critical post-kidney transplantation (KT) complications. We evaluated age-stratified screening practices, treatment patterns, and fracture incidence in a nationwide KT cohort.Methods
Using the Korean National Health Insurance Service database (2003-2020), we analyzed 34 758 adult KT recipients. Screening practices (bone mineral density [BMD] testing), medication continuity, and incident fractures were assessed across age groups (< 50, 50-64, ≥ 65 years).Results
During a median follow-up of 8.4 years, 63.8% of recipients underwent BMD testing, but only 29.9% were screened within the first year post-transplant. Overall fracture incidence was 1.2/100 person-years (PY), increasing to 3.9/100 PY in recipients aged ≥ 65 (IRR 5.41 vs. < 50 years). The excess fracture risk in older recipients persisted across all post-transplant time intervals (adjusted SHR 4.18, 4.23, and 3.61 for < 1, 1-5, and ≥ 5 years, respectively). Despite a 5.2- to 7.6-fold increase in post-KT fracture risk associated with a pre-transplant fracture history, screening practices were not consistently intensified among younger patients with prior fractures.Conclusions
Post-transplant bone health management is characterized by delayed assessment and insufficient risk-stratified screening. Risk-adapted strategies are necessary to improve early screening and sustained therapy, particularly for high-risk recipients.
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BibTeX
@article{kim2026discordance,
title = {{Discordance Between Fracture Risk and Bone Health Management After Kidney Transplantation: A Nationwide Cohort Study.}},
author = {Ji Eun Kim and Chan Mi Park and Seung Min Song and Min Woo Kang and Hyo Jin Kim and Eun Jung Cho and Gang Jee Ko and Young Joo Kwon},
journal = {Clinical transplantation},
year = {2026},
month = oct,
doi = {10.1111/ctr.70704},
url = {https://europepmc.org/article/MED/42911615},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Discordance Between Fracture Risk and Bone Health Management After Kidney Transplantation: A Nationwide Cohort Study.
AU - Ji Eun Kim
AU - Chan Mi Park
AU - Seung Min Song
AU - Min Woo Kang
AU - Hyo Jin Kim
AU - Eun Jung Cho
AU - Gang Jee Ko
AU - Young Joo Kwon
PY - 2026
DA - 2026/10/01
JO - Clinical transplantation
DO - 10.1111/ctr.70704
UR - https://europepmc.org/article/MED/42911615
AB - Background Bone loss and fractures are critical post-kidney transplantation (KT) complications. We evaluated age-stratified screening practices, treatment patterns, and fracture incidence in a nationwide KT cohort.Methods Using the Korean National Health Insurance Service database (2003-2020), we analyzed 34 758 adult KT recipients. Screening practices (bone mineral density [BMD] testing), medication continuity, and incident fractures were assessed across age groups (< 50, 50-64, ≥ 65 years).Results During a median follow-up of 8.4 years, 63.8% of recipients underwent BMD testing, but only 29.9% were screened within the first year post-transplant. Overall fracture incidence was 1.2/100 person-years (PY), increasing to 3.9/100 PY in recipients aged ≥ 65 (IRR 5.41 vs. < 50 years). The excess fracture risk in older recipients persisted across all post-transplant time intervals (adjusted SHR 4.18, 4.23, and 3.61 for < 1, 1-5, and ≥ 5 years, respectively). Despite a 5.2- to 7.6-fold increase in post-KT fracture risk associated with a pre-transplant fracture history, screening practices were not consistently intensified among younger patients with prior fractures.Conclusions Post-transplant bone health management is characterized by delayed assessment and insufficient risk-stratified screening. Risk-adapted strategies are necessary to improve early screening and sustained therapy, particularly for high-risk recipients.
SN - 0902-0063
SN - 1399-0012
ER -