{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:54:58Z","timestamp":1789091698868,"version":"build-2803163510"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T00:00:00Z","timestamp":1619740800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney transplantation (KT) recipients are at increased risk of low bone density (LBD) and fractures. In this retrospective study, we investigated bone mineral density (BMD), vertebral fractures, calculated risk for major osteoporotic fractures (MOF), and hip fractures in the KT recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Patients-method<\/jats:title>\n                    <jats:p>Patients who completed at least one year after KT were included in the analysis. Demographic, clinical, and laboratory data were recorded. Measurements of BMD were performed by dual-energy X-ray absorptiometry. Vertebral fractures were assessed using semi-quantitative criteria with conventional radiography. The ten-year risk for MOF and hip fracture were calculated using the FRAX@ tool with BMD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred fifty-three KT recipients were included in the study. The population included 77 women. The mean age at evaluation was 46,5\u00b111,9 years. Seventy-eight (50.9%) patients had normal femoral neck BMD while osteoporosis and osteopenia at the femoral neck were present in 12 (7.8%) and 63 (41.1%) of the patients, respectively. Age at evaluation was the risk factor for LBD (OR 1.057; 95% CI 1.024\u20131.091; p = 0.001). In female KT recipients, LBD was principally affected by menopausal status whereas in males, mammalian target of rapamycin (mTOR) inhibitor use and lower BMI levels were the risk factors. The prevalent vertebral fracture was found in 43.4% of patients. In multivariate analysis, only steroid use (OR 0.121; 95% CI 0.015\u20130.988; p = 0.049) was found to be associated with prevalent fracture. Among all KT recipients, 1.9% had a high MOF probability (\u226520% risk of fracture), and 23.5% had high hip fracture probability (\u22653% risk of hip fracture) according to FRAX.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exploring the prevalence of LBD and vertebral fracture and the risk factors would help clinicians to modify long-term follow-up strategies. Furthermore, the high hip fracture risk probability in our cohort suggested that there is a need for longitudinal studies to confirm the validity of the FRAX tool in the transplant population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0251035","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T13:39:07Z","timestamp":1619789947000},"page":"e0251035","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":15,"title":["Low bone density, vertebral fracture and FRAX score in kidney transplant recipients: A cross-sectional cohort study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9750-7585","authenticated-orcid":true,"given":"Arzu","family":"Velioglu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8944-3526","authenticated-orcid":true,"given":"Burcu","family":"Kaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basar","family":"Aykent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2745-1189","authenticated-orcid":true,"given":"Bige","family":"Ozkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melis Sevil","family":"Karapinar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakki","family":"Arikan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebru","family":"Asicioglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6011-2720","authenticated-orcid":true,"given":"Onur","family":"Bugdayc\u0131","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dilek Gogas","family":"Yavuz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serhan","family":"Tuglular","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"issue":"1","key":"pone.0251035.ref001","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.kint.2017.04.006","article-title":"Executive summary of the 2017 KDIGO Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Guideline Update: what\u2019s changed and why it matters","volume":"92","author":"M Ketteler","year":"2017","journal-title":"Kidney Int"},{"key":"pone.0251035.ref002","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s00198-009-1034-7","article-title":"The potential impact of new National Osteoporosis Foundation guidance on treatment patterns","volume":"21","author":"B Dawson-Hughes","year":"2010","journal-title":"Osteoporos Int"},{"issue":"1","key":"pone.0251035.ref003","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s11739-018-1874-2","article-title":"Guidelines for the management of osteoporosis and fragility fractures","volume":"14","author":"R Nuti","year":"2019","journal-title":"Intern Emerg Med"},{"issue":"4","key":"pone.0251035.ref004","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1359\/JBMR.041214","article-title":"Underdiagnosis of vertebral fractures is a worldwide problem: the IMPACT study","volume":"20","author":"PD Delmas","year":"2005","journal-title":"J Bone Miner Res"},{"issue":"7","key":"pone.0251035.ref005","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1016\/j.transproceed.2007.07.073","article-title":"Prevalence of osteoporosis, osteopenia, and vertebral fractures in long-term renal transplant recipients","volume":"39","author":"R Marc\u00e9n","year":"2007","journal-title":"Transplant Proc"},{"issue":"2","key":"pone.0251035.ref006","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/ctr.12666","article-title":"Bone fractures and lumbar mineral density after renal transplantation. 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