CKD and risk of new fragility fractures following first hip fracture

  • de Bruin IJA & al.
  • Osteoporos Int
  • 7 Apr 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Chronic kidney disease (CKD) stages G3-G5 (estimated glomerular filtration rate [eGFR],60 mL/min.
  • CKD stages G4 (eGFR 15–29 ml/min/1.73 m2) and G5 (eGFR2) were associated with a higher risk of mortality.

Why this matters

  • The elevated mortality risk may as competing risk explain that CKD stages G3-G5 should not be considered as an important additional risk factor for subsequent fractures in this population.

Study design

  • This retrospective population-based cohort study included 37,820 patients with a hip fracture using data from the UK Clinical Practice Research Datalink GOLD.
  • Of 37,820 patients, 23,780 had CKD (13,047 with eGFR >60 mL/min and 10,733 with CKD stages G3-G5).
  • Funding: None disclosed.

Key results

  • Compared with eGFR >60 mL/min, CKD G3-G5 was associated with a lower risk of any subsequent non-hip fracture (HR, 0.90; 95% CI, 0.83-0.97), but not with the risk of subsequent major non-hip fragility fracture.
  • Patients with CKD stages G3-G5 were at a higher risk for mortality compared with those with eGFR >60 mL/min (cause-specific [cs] HR, 1.05; 95% CI, 1.01-1.09).
  • The risk for mortality was 1.5-fold to 3-fold higher in patients with CKD stages G4 (cs-HR, 1.50; 95% CI, 1.38-1.62) and G5 (cs-HR, 2.93; 95% CI, 2.48-3.46) vs those with eGFR >60 mL/min.

Limitations

  • Study included only community-dwelling patients.