Abstract：
OBJECTIVE: Kidney transplant recipients are at high risk of fracture due to many factors such as nutritional status, hyperparathyroidism, acidosis and steroid administration. The current meta-analysis aimed to comprehensively analyse the incidence and risk factors of fracture in kidney transplant recipients.
METHODS: A systematic search on Embase, Web of Science, PubMed and Cochrane Library until November 2023 was performed. RStudio software was used to analyse data.
RESULTS: Twenty-eight eligible studies containing 310 530 kidney transplant recipients were included in the analysis. The pooled incidence of fracture was 10% (95% confidence interval [CI]: 7%-13%) generally. When divided by regions, it was further observed that the pooled incidence of fracture was 13% (95% CI: 9%-17%) in Europe, 11% (95% CI: 6%-16%) in North America, 7% (95% CI: 3%-11%) in Asia. Regarding the risk factors, pooled analysis revealed that age of recipient (hazard ratio [HR] = 1.50, 95% CI: 1.17-1.91), female sex (HR = 1.45, 95% CI: 1.36-1.53), pretransplantation diabetes (HR = 1.76, 95% CI: 1.58-1.97), pretransplantation fracture history (HR = 2.28, 95% CI: 1.86-2.78), dialysis duration (HR = 1.09, 95% CI: 1.01-1.17) and deceased donor (HR = 1.21, 95% CI: 1.05-1.39) related to higher risk of fracture. The general quality of included studies was acceptable, and no publication bias existed except for the analysis between age of recipient and fracture incidence; further trim and fill method indicated age of recipient showed a correlation trend with the fracture incidence without the statistical significance.
CONCLUSIONS: The pooled incidence of fracture reaches 10% in kidney transplant recipients, which relates to age of recipient, female sex, pretransplantation diabetes or fracture history, dialysis duration and decease donor.
METHODS: A systematic search on Embase, Web of Science, PubMed and Cochrane Library until November 2023 was performed. RStudio software was used to analyse data.
RESULTS: Twenty-eight eligible studies containing 310 530 kidney transplant recipients were included in the analysis. The pooled incidence of fracture was 10% (95% confidence interval [CI]: 7%-13%) generally. When divided by regions, it was further observed that the pooled incidence of fracture was 13% (95% CI: 9%-17%) in Europe, 11% (95% CI: 6%-16%) in North America, 7% (95% CI: 3%-11%) in Asia. Regarding the risk factors, pooled analysis revealed that age of recipient (hazard ratio [HR] = 1.50, 95% CI: 1.17-1.91), female sex (HR = 1.45, 95% CI: 1.36-1.53), pretransplantation diabetes (HR = 1.76, 95% CI: 1.58-1.97), pretransplantation fracture history (HR = 2.28, 95% CI: 1.86-2.78), dialysis duration (HR = 1.09, 95% CI: 1.01-1.17) and deceased donor (HR = 1.21, 95% CI: 1.05-1.39) related to higher risk of fracture. The general quality of included studies was acceptable, and no publication bias existed except for the analysis between age of recipient and fracture incidence; further trim and fill method indicated age of recipient showed a correlation trend with the fracture incidence without the statistical significance.
CONCLUSIONS: The pooled incidence of fracture reaches 10% in kidney transplant recipients, which relates to age of recipient, female sex, pretransplantation diabetes or fracture history, dialysis duration and decease donor.
摘要：
目的：由于营养状况等多种因素，肾移植受者骨折的风险很高，甲状旁腺功能亢进,酸中毒和类固醇给药。目前的荟萃分析旨在全面分析肾移植受者骨折的发生率和危险因素。
方法：在Embase上进行系统搜索，WebofScience,PubMed和Cochrane图书馆直到2023年11月才进行。使用RStudio软件分析数据。
结果：28项符合条件的研究纳入分析，包括310530例肾移植受者。骨折的合并发生率通常为10％（95％置信区间[CI]：7％-13％）。当按地区划分时，进一步观察到，欧洲的骨折合并发生率为13％（95％CI：9％-17％），北美11%（95%CI：6%-16%），亚洲7%(95%CI:3%-11%)。关于风险因素，汇总分析显示，接受者的年龄(风险比[HR]=1.50，95%CI：1.17-1.91)，女性（HR=1.45，95%CI：1.36-1.53），移植前糖尿病（HR=1.76，95%CI：1.58-1.97），移植前骨折史（HR=2.28，95%CI：1.86-2.78），透析时间(HR=1.09,95%CI:1.01-1.17)和死亡供者(HR=1.21,95%CI:1.05-1.39)与较高的骨折风险相关.纳入研究的总体质量是可以接受的，除受者年龄与骨折发生率之间的分析外，不存在发表偏倚；进一步修剪填充法显示受者年龄与骨折发生率呈相关趋势，但无统计学意义。
结论：肾移植受者的合并骨折发生率达到10%，这与接受者的年龄有关，女性性别,移植前糖尿病或骨折史，透析持续时间和减少供体。
方法：在Embase上进行系统搜索，WebofScience,PubMed和Cochrane图书馆直到2023年11月才进行。使用RStudio软件分析数据。
结果：28项符合条件的研究纳入分析，包括310530例肾移植受者。骨折的合并发生率通常为10％（95％置信区间[CI]：7％-13％）。当按地区划分时，进一步观察到，欧洲的骨折合并发生率为13％（95％CI：9％-17％），北美11%（95%CI：6%-16%），亚洲7%(95%CI:3%-11%)。关于风险因素，汇总分析显示，接受者的年龄(风险比[HR]=1.50，95%CI：1.17-1.91)，女性（HR=1.45，95%CI：1.36-1.53），移植前糖尿病（HR=1.76，95%CI：1.58-1.97），移植前骨折史（HR=2.28，95%CI：1.86-2.78），透析时间(HR=1.09,95%CI:1.01-1.17)和死亡供者(HR=1.21,95%CI:1.05-1.39)与较高的骨折风险相关.纳入研究的总体质量是可以接受的，除受者年龄与骨折发生率之间的分析外，不存在发表偏倚；进一步修剪填充法显示受者年龄与骨折发生率呈相关趋势，但无统计学意义。
结论：肾移植受者的合并骨折发生率达到10%，这与接受者的年龄有关，女性性别,移植前糖尿病或骨折史，透析持续时间和减少供体。
