Objectives:
Fractures are associated with high morbidity and are a major concern to kidney transplant recipients. There has not been any comparative analysis conducted between countries in the contemporary era to inform future international prevention trials.
Materials and Methods:
Data were obtained from the Hospital Episode Statistics and the Statewide Planning and Research Cooperative databases on all adult kidney transplants performed in England and New York State respectively (2003-2013) and on post-transplant fracture-related hospitalization (2003-2014).
Results:
In total, 18,493 English and 11,602 New York State kidney transplant recipients were included. Overall, 637 (3.4%) English and 398 (3.4%) New York State recipients sustained a fracture giving an unadjusted event rate of 7.0 and 5.9 per 1000 years respectively (P=0.948). A total of 147 (0.8%) English and 101 (0.9%) New York State recipients sustained a hip fracture, giving an unadjusted event rate of 1.6 and 1.5 per 1000 years respectively (P=0.480). There were no differences in the cumulative incidence of all fractures or hip fractures. One-year mortality after any fracture (9% and 11%) or after a hip fracture (15% and 17%) was not different between cohorts.
Conclusions:
Contemporaneous English and New York State kidney transplant recipients have very similar fracture rates and mortality post-fracture
