Incidence of bone fractures among patients on maintenance hemodialysis.

Autor: Kashgary A; Department of Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia., Attiah FOA; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., AlKhateeb NA; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Abdulaziz NH; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Alsaif BA; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Aljuhani AF; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia., Abdalbary M; Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt., Nagy E; Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt., Abdelsalam M; Mansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Jazyk: angličtina
Zdroj: Renal failure [Ren Fail] 2023 Dec; Vol. 45 (1), pp. 2224456.
DOI: 10.1080/0886022X.2023.2224456
Abstrakt: Background: Patients with chronic kidney disease, especially those undergoing hemodialysis (HD), have a higher risk of fragility fractures. However, the magnitude of the problem and risk factors associated with fracture incidence have not been well studied in the Kingdom of Saudi Arabia.
Methods: This multicenter retrospective study involved HD centers in Jeddah from 2015 to 2021. This study included all adult HD patients. Patient demographics, medication usage, and clinical and biochemical parameters were collected from the registry records.
Results: The study included 328 patients on HD, with a mean age of 53 years. The median duration of HD was 47 months. Osteoporosis was found in 9% of the patients, and 8% had a previous parathyroidectomy. Over the observation period, fractures occurred in 32 patients, with an incidence rate of 20 case/1000 end stage kidney disease patients-year. Patients with fractures had a higher rate of osteoporosis, underwent more parathyroidectomy, had longer HD vintage, and higher bone-specific alkaline phosphatase (BSAP) levels. BSAP was the most significant predictor of fracture incidence in the regression analysis. Using a BSAP cutoff value of 96.6 µg/L, the sensitivity and specificity to predict fractures were 81.8% and 49%, respectively.
Conclusion: The main risk factors for incident fractures were osteoporosis, previous parathyroidectomy, longer HD vintage, and higher BSAP level. A higher BSAP score was the most significant predictor of incident fractures. This may highlight the importance of monitoring bone turnover markers and the negative impact of high bone turnover on patient health.
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje