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Event Date: 

Wednesday, February 27, 2019 - 12:00pm

Event Location: 

WARF 758

Contact Info: 

Rosalind Bendix-Lewis Rosalind.bendixlewis@wisc.edu, (608) 265-0516

PHS 820 Graduate Student Seminar-Beini Lyu, Epidemiology PhD Student: "Proton Pump Inhibitor Use and Major Fractures in Kidney Transplant Recipients"

Background: Fracture is a significant problem among kidney transplant recipients (KTRs). Proton pump inhibitors (PPIs) are among the most commonly prescribed drugs in KTRs and have been associated with higher risk of fractures in the general population. This study aims to determine whether PPI use is associated with increased risk of major fractures in KTRs.

Method : The study is a nested case control study. Using the Wisconsin Allograft Recipient Database, we identified 155 major fracture events which occurred at least 12 months after transplantation between 2000 and 2015. Each eligible case was matched on index fracture date with 5 controls on time since transplantation, age, sex, race, transplantation year (+/- 3 years), living versus deceased donor and whether or not had a prior transplantation. PPI use covering 12 months before the index date was identified. Association between past 12 months PPI use and risk of major fractures was assessed by conditional logistic regression.

Primary results : We identified 155 cases and 685 controls. Cases had higher proportions of diabetes, cardiovascular disease and acute rejection events. 57.4% of cases and 40.2% of controls had prior PPI use. PPI use was associated with higher risk of major fractures in unadjusted analysis (OR=2.4, 95% CI: 1.6-3.5). The association remained when adjusting for demographic and transplant related covariates (OR=2.0, 95% CI: 1.3-3.2).

Tentative conclusions : PPI use might be associated with higher risk of major fractures among KTRs. However, other covariates associated with bone health in KTRs should be assessed and further incorporated in analyses.

Stage of research: Cleaning and analyzing data.