Increasing Hip Fractures in Patients Receiving Hemodialysis and Peritoneal Dialysis

被引:32
作者
Mathew, Anna T. [1 ,2 ]
Hazzan, Azzour [1 ,2 ]
Jhaveri, Kenar D. [1 ,2 ]
Block, Geoffrey A. [3 ]
Chidella, Shailaja [1 ,2 ]
Rosen, Lisa [1 ,2 ]
Wagner, John [4 ]
Fishbane, Steve [1 ,2 ]
机构
[1] N Shore Univ Hosp, Hofstra NSLIJ Sch Med, Great Neck, NY USA
[2] Long Isl Jewish Med Ctr, Great Neck, NY USA
[3] Denver Nephrologists PC, Denver, CO USA
[4] Suny Downstate Med Ctr, Coll Med, Kings Cty Hosp Ctr, Brooklyn, NY 11203 USA
关键词
Dialysis; End stage renal disease; Fracture; Mineral and bone disorders; TEMPORAL TRENDS; RISK; MORTALITY;
D O I
10.1159/000369039
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background/Aims: Dialysis patients are at increased risk for hip fractures. Because changes in treatment of metabolic bone disease in this population may have impacted bone fragility, this study aims to analyze the longitudinal risk for fractures in hemodialysis (HD) and peritoneal dialysis (PD) patients. Methods: Using the United States Renal Data System database from 1992 to 2009, the temporal trend in hip fractures requiring hospitalization was analyzed using an overdispersed Poisson regression model. Generalized Estimating Equations were used to assess the adjusted effect of dialysis modality on hip fractures. Results: 842,028 HD and 87,086 PD patients were included. There was a significant temporal increase in hip fractures in both HD and PD with stabilization of rates after 2005. With stratification, the increase in fractures occurred in patients who were white and over 65 years of age. In adjusted analyses, HD patients had 1.6 times greater odds of hip fracture than PD patients (OR 1.60 95% CI 1.52, 1.68, p < 0.001). Conclusions: In contrast to the declining hip fracture rates in the general population, we identified a temporal rise in incidence of hip fractures in HD and PD patients. HD patients were at a higher risk for hip fractures than PD patients after adjustment for recognized bone fragility risk factors. The increase in fracture rate over time was limited to older white patients in both HD and PD, the demographics being consistent with osteoporosis risk. Further research is indicated to better understand the longitudinal trend in hip fractures and the discordance between HD and PD. (C) 2014 S. Karger AG, Basel
引用
收藏
页码:451 / 457
页数:7
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