Effects of bisphosphonates on long-Term kidney transplantation outcomes

Seung Hwan Song, Hoon Young Choi, Ha Yan Kim, Chung Mo Nam, Hyeon Joo Jeong, Myoung Soo Kim, Soon I.I. Kim, Yu Seun Kim, Kyu Ha Huh, Beom Seok Kim

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3 Scopus citations


Background: Bisphosphonates are administered to post-Transplantation patients with mineral and bone disorders; however, the association between bisphosphonate therapy and long-Term renal graft survival remains unclear. Methods: This nested case-control study investigated the effects of bisphosphonates on long-Term graft outcomes after kidney transplantation. We enrolled 3836 kidney transplant recipients treated from April 1979 to June 2016 and matched patients with graft failure to those without (controls). Annual post-Transplant bone mineral density assessments were performed and recipients with osteopenia or osteoporosis received bisphosphonate therapy. The associations between bisphosphonate use and long-Term graft outcomes and graft survival were analyzed using conditional logistic regression and landmark analyses, respectively. Results: A landmark analysis demonstrated that death-censored graft survival was significantly higher in bisphosphonate users than in non-users in the entire cohort (log-rank test, P < 0.001). In the nested case-control matched cohort, bisphosphonate users had a significantly reduced risk of graft failure than did non-users (odds ratio = 0.38; 95% confidence interval 0.30-0.48). Bisphosphonate use, increased cumulative duration of bisphosphonate use >1 year and increased cumulative bisphosphonate dose above the first quartile were associated with a reduced risk of graft failure, after adjustments. Conclusions: Bisphosphonates may improve long-Term graft survival in kidney transplant recipients.

Original languageEnglish
Pages (from-to)722-729
Number of pages8
JournalNephrology Dialysis Transplantation
Issue number4
StatePublished - 1 Apr 2021

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.


  • bisphosphonates
  • graft outcomes
  • graft survival
  • kidney transplant


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