Proteinuria, reduced eGFR tied to increased risk for osteoporosis

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Takeaway

  • Dipstick proteinuria and reduced estimated glomerular filtration rate (eGFR) are independent risk factors for osteoporosis.
  • Proteinuria is known to contribute to vitamin D deficiency and dysfunction of osteoblasts, but the biological rationale for lower eGFR and osteoporosis is unknown.

Why this matters

  • Patients with these risk factors may warrant more frequent osteoporosis screening.

Study design

  • Cross-sectional cohort of 21,271 participants in a community-based health survey in Taiwan.
  • Positive proteinuria was presence of 1+ or more urinary proteins on the dipstick (≥30 mg/dL).
  • eGFR was categorized into tertiles (highest was ≥60 mL/minute/1.73 m2, middle was ≥30 to 2, and lowest was 2).
  • Osteoporosis was defined by a T-score of ≤−2.5, measured by calcaneal quantitative ultrasound.
  • Funding: Chiayi County Health Bureau, Taiwan.

Key results

  • On multivariate analysis, participants with 1+ proteinuria were at 15% higher risk for osteoporosis (aOR, 1.15; 95% CI, 1.02-1.32) and those with ≥2+ proteinuria (>100 mg/dL) were at 18% higher risk (aOR, 1.18; 95% CI, 1.05-1.33).
  • Participants in the middle and lowest eGFR tertiles (relative to the highest tertile) were at higher risk for osteoporosis (aORs, 1.31 [95% CI, 1.20-1.44] and 2.46 [95% CI, 1.73-3.48], respectively).

Limitations

  • Cross-sectional design.