 |
|
Renal Function and Risk of Hip and Vertebral Fractures in Older Women
Kristine E. Ensrud, MD, MPH;
Li-Ying Lui, MA, MS;
Brent C. Taylor, PhD;
Areef Ishani, MD, MS;
Michael G. Shlipak, MD, MPH;
Katie L. Stone, PhD;
Jane A. Cauley, DrPH;
Sophie A. Jamal, MD, PhD;
Diana M. Antoniucci, MD;
Steven R. Cummings, MD; for the Study of Osteoporotic Fractures Research Group
Arch Intern Med. 2007;167(2):133-139.
Background An increased rate of hip fractures has been reported in patients with end-stage renal disease, but the effect of less severe renal dysfunction on fracture risk is uncertain.
Methods We conducted a case-cohort study within a cohort of 9704 women 65 years or older to compare baseline renal function (estimated glomerular filtration rate [eGFR] using the Cockcroft-Gault equation) in 149 women who subsequently had hip fractures and 150 women who subsequently had vertebral fractures with eGRF in 396 randomly selected women.
Results In models adjusted for age, weight, and calcaneal bone density, decreasing eGFR was associated with increased risk of hip fracture. Compared with women with an eGFR 60 mL/min per 1.73 m2 or greater, the hazard ratio (95% confidence interval [CI]) for hip fracture was 1.57 (95% CI, 0.89-2.76) in those with an eGFR 45 to 59 mL/min per 1.73 m2 and 2.32 (95% CI, 1.15-4.68) in those with an eGFR less than 45 mL/min per 1.73 m2 (P for trend = .02). In particular, women with a reduced eGFR were at increased risk of trochanteric hip fracture (adjusted hazard ratio, 3.93 [95% CI, 1.37-11.30] in women with an eGFR 45-59 mL/min per 1.73 m2 and 7.17 [95% CI, 1.93-26.67] in women with an eGFR <45 mL/min per 1.73 m2; P for trend = .004). Renal function was not independently associated with risk of vertebral fracture (adjusted odds ratio, 1.08 [95% CI, 0.61-1.92] in women with an eGFR 45-59 mL/min per 1.73 m2 and 1.33 [95% CI, 0.63-2.80] in women with an eGFR <45 mL/min per 1.73 m2; P for trend = .47).
Conclusion Older women with moderate renal dysfunction are at increased risk of hip fracture.
Author Affiliations: Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis (Drs Ensrud, Taylor, and Ishani), and Department of Medicine (Drs Ensrud and Ishani) and Division of Epidemiology and Community Health, University of Minnesota (Dr Ensrud), Minneapolis; San Francisco Coordinating Center, California Pacific Medical Center Research Institute (Ms Lui, and Drs Stone and Cummings); Departments of Medicine (Drs Shlipak and Antoniucci) and Epidemiology and Biostatistics (Dr Shlipak), University of California, San Francisco, and General Internal Medicine,VA Medical Center, San Francisco, Calif (Dr Shlipak); Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pa (Dr Cauley); and Department of Medicine, Division of Endocrinology and Metabolism, St Michael's Hospital, University of Toronto, Toronto, Ontario (Dr Jamal). Dr Antoniucci is also now with the Endocrine Research Unit, VA Medical Center, San Francisco, Calif.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
RELATED LETTERS
Glomerular Filtration Rate Results Reflect Estimation
Micah L. Thorp
Arch Intern Med. 2007;167(17):1905-1906.
EXTRACT
| FULL TEXT
Glomerular Filtration Rate Results Reflect Estimation—Reply
Kristine E. Ensrud, Areef Ishani, Brent C. Taylor, and Li-Yung Lui
Arch Intern Med. 2007;167(17):1906.
EXTRACT
| FULL TEXT
RELATED ARTICLE
Renal Function and Risk of Hip and Vertebral Fractures in Older Women: Is It Always Osteoporosis?
Stuart M. Sprague
Arch Intern Med. 2007;167(2):115-116.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Serum phosphorus predicts incident chronic kidney disease and end-stage renal disease
O'Seaghdha et al.
Nephrol Dial Transplant 2011;26:2885-2890.
ABSTRACT
| FULL TEXT
Mineral Metabolism Markers and the Long-Term Risk of Hip Fracture: The Cardiovascular Health Study
Robinson-Cohen et al.
J. Clin. Endocrinol. Metab. 2011;96:2186-2193.
ABSTRACT
| FULL TEXT
A Multi-Marker Approach to Predict Incident CKD and Microalbuminuria
Fox et al.
J. Am. Soc. Nephrol. 2010;21:2143-2149.
ABSTRACT
| FULL TEXT
Mild Renal Dysfunction Is a Risk Factor for a Decrease in Bone Mineral Density and Vertebral Fractures in Japanese Postmenopausal Women
Kaji et al.
J. Clin. Endocrinol. Metab. 2010;95:4635-4642.
ABSTRACT
| FULL TEXT
Bone Mass and Microarchitecture in CKD Patients with Fracture
Nickolas et al.
J. Am. Soc. Nephrol. 2010;21:1371-1380.
ABSTRACT
| FULL TEXT
Vitamin D receptor gene, biochemical bone markers and bone mineral density in Mexican women on dialysis
Avila et al.
Nephrol Dial Transplant 2010;25:2259-2265.
ABSTRACT
| FULL TEXT
Pentosidine and Increased Fracture Risk in Older Adults with Type 2 Diabetes
Schwartz et al.
J. Clin. Endocrinol. Metab. 2009;94:2380-2386.
ABSTRACT
| FULL TEXT
Peripheral Arterial Disease Is Associated With Higher Rates of Hip Bone Loss and Increased Fracture Risk in Older Men
Collins et al.
Circulation 2009;119:2305-2312.
ABSTRACT
| FULL TEXT
Chronic kidney disease and hip fracture-related mortality in older people in the UK
Nitsch et al.
Nephrol Dial Transplant 2009;24:1539-1544.
ABSTRACT
| FULL TEXT
Serum 25-Hydroxyvitamin D Concentrations and Risk for Hip Fractures
Cauley et al.
ANN INTERN MED 2008;149:242-250.
ABSTRACT
| FULL TEXT
Hypovitaminosis D in Chronic Kidney Disease
Mehrotra et al.
CJASN 2008;3:1144-1151.
ABSTRACT
| FULL TEXT
The Effect of Raloxifene Treatment in Postmenopausal Women with CKD
Ishani et al.
J. Am. Soc. Nephrol. 2008;19:1430-1438.
FULL TEXT
Glomerular Filtration Rate Results Reflect Estimation Reply
Ensrud et al.
Arch Intern Med 2007;167:1906-1906.
FULL TEXT
Glomerular Filtration Rate Results Reflect Estimation
Thorp
Arch Intern Med 2007;167:1905-1906.
FULL TEXT
The Hip Bone's Connected to the Kidney?
JWatch Women's Health 2007;2007:2-2.
FULL TEXT
Renal Function and Risk of Hip and Vertebral Fractures in Older Women: Is It Always Osteoporosis?
Sprague
Arch Intern Med 2007;167:115-116.
FULL TEXT
|
