CKD: prolonged hyponatremia tied to hip fracture in elders

  • Nigwekar SU & al.
  • Bone
  • 27 Jul 2019

  • International Clinical Digest
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Takeaway

  • Chronic prolonged hyponatremia (CPH) is tied to 36% increased odds of hip fracture among older patients with chronic kidney disease (CKD).

Why this matters

  • The association was consistent in patients with or without osteoporosis.

Study design

  • Case-control study of patients aged >60 years with stage ≥III CKD (stage III, 84%).
  • 1236 had hip fractures (mean age, 84±9 years) and 4515 matched patients did not (mean age, 83±9 years).
  • CPH was defined as serum sodium
  • Funding: None disclosed.

Key results

  • CPH was more common with hip fracture (21% vs 10%; P<.001 and primarily mild meq cases controls>
  • Univariate analysis tied CPH to higher odds of hip fracture (OR, 2.44; 95% CI, 2.07-2.89).
  • In multivariate analysis, risk was attenuated but remained significant (aOR, 1.36; 95% CI, 1.04-1.78).
  • The association was consistent in osteoporosis presence (OR, 2.45; 95% CI, 1.60-3.74) and absence (OR, 2.38; 95% CI, 1.98-2.87), and also without falls (OR, 1.76; 95% CI, 1.25-2.47).
  • Odds of hip fracture with CPH were elevated among patients aged ≤70 years (OR, 4.02; 95% CI, 2.66-6.09) and >70 years (OR, 2.24; 95% CI, 1.86-2.70).
  • CPH severity was not a factor, but duration >180 days conferred significant risk (OR, 1.45; 95% CI, 1.08-1.95).

Limitations

  • Observational design.