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Bisphosphonate Use Improves in Patients With Osteopenia and Prior Fractures Following an Osteoporosis Educational Intervention:Canadian Quality Circle （CQC） National Project

Bisphosphonate Use Improves in Patients With Osteopenia and ...

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第三届国际骨质疏松及骨矿盐疾病学术会议

作者： J.F.Chiu G.Ioannidis L.Thabane A.Gafni A.Papaioannou B.Kvern a.hodsman D.Johnstone J.D.Adachi University of Alberta Edmonton McMaster University Hamilton McMaster University Hamilton McMaster University Hamilton McMaster University Hamilton Ur University of Manitoba Winnipeg University of Western Ontario London Procter and Gamble Pharmaceuticals Toronto all in Canada McMaster University Hamilton

＜正＞Aim:The project was developed to improve primary care physicians’（PCPs）management of osteoporosis in accordance with the Canadian 2002 Guidelines. Methods:The study consisted of five phases: wave（?）data col...

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Risk factors for fracture in adult kidney transplant recipients

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World Journal of Transplantation 2016年第2期6卷 370-379页

作者： Kyla L Naylor Guangyong Zou William D Leslie Anthony B hodsman Ngan N Lam Eric McArthur Lisa-Ann Fraser Gregory A Knoll Jonathan D Adachi S Joseph Kim Amit X Garg Institute for Clinical Evaluative Sciences 2nd Institute of Health Policy Management and EvaluationUniversity of Toronto Department of Epidemiology and Biostatistics Western University Department of Medicine University of Manitoba Division of Nephrology Western University Division of Nephrology University of Alberta Division of Endocrinology Western University Division of Nephrology Kidney Research CentreOttawa Hospital Research InstituteUniversity of Ottawa Division of Rheumatology McMaster University Division of Nephrology University Health NetworkUniversity of Toronto

AIM: To determine the general and transplant-specific risk factors for fractures in kidney transplant ***: We conducted a cohort study of all adults who received a kidney-only transplant(n = 2723) in Ontario, Canada between 2002 and 2009. We used multivariable Cox proportional hazards regression to determine general and transplant-specific risk factors for major fractures(proximal humerus, forearm, hip, and clinical vertebral). The final model was established using the backward elimination strategy, selecting risk factors with a P-value ≤ 0.2 and forcing recipient age and sex into the model. We also assessed risk factors for other fracture locations(excluding major fractures, and fractures involving the skull, hands or feet). RESULTS: There were 132 major fractures in the follow-up(8.1 fractures per 1000 person-years). General risk factors associated with a greater risk of major fracture were older recipient age [adjusted hazard ratio(a HR) per 5-year increase 1.11, 95%CI: 1.03-1.19] and female sex(a HR = 1.81, 95%CI: 1.28-2.57). Transplant-specific risk factors associated with a greater risk of fracture included older donor age(5-year increase)(a HR = 1.09, 95%CI: 1.02-1.17) and end-stage renal disease(ESRD) caused by diabetes(a HR = 1.72, 95%CI: 1.09-2.72) or cystic kidney disease(a HR = 1.73, 95%CI: 1.08-2.78)(compared to glomerulonephritis as the reference cause). Risk factors across the two fracture locations were not consistent(major fracture locations vs other). Specifically, general risk factors associated with an increased risk of other fractures were diabetes and a fall with hospitalization prior to transplantation, while length of time on dialysis, and renal vascular disease and other causes of ESRD were the transplant-specific risk factors associated with a greater risk of other ***: Both general and transplant-specific risk factors were associated with a higher risk of fractures in kidney transplant recipients. Results ca

关键词： Fracture Risk factors Kidney transplant recipient Prognostication Cohort study

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