Dementia is a major risk factor for hip fractures in patients with chronic kidney disease
Dementia is a major risk factor for hip fractures in patients with chronic kidney disease
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DOI：
10.1007/s00198-015-3429-y
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发表时间：
2016-04-01
影响因子：
4
通讯作者：
Cohen-Solal, M.
中科院分区：
文献类型：
--
作者：
Maravic, M.;Ostertag, A.;Cohen-Solal, M.
慢性肾病会增加髋部骨折的风险，而痴呆症可能会加剧髋部骨折。我们在此表明，痴呆症会增加透析患者髋部骨折的风险，但其方式与未进行透析的患者相似。应关注痴呆症以预防髋部骨折。髋部骨折（HF）与显着的发病率相关，并且在慢性肾病（CKD）患者中进一步增加。慢性肾病中常见的痴呆可能是心力衰竭的危险因素。我们的目的是评估痴呆症是否会增加 CKD 患者髋部骨折的风险。该研究来自法国国家住院数据库。数据是在 2011 年至 2013 年期间获得的。提取了三个> 60 岁的受试者群体。髋部骨折、透析和痴呆是主要研究因素。对这三个人群进行交叉分析，根据痴呆或透析来估计骨折风险，并根据年龄和性别进行调整。使用多元逻辑回归模型计算骨折风险。在此期间，213,180 名患者经历了心力衰竭，660,434 名患者被诊断为痴呆，47,430 名患者接受透析。年龄和性别对心力衰竭和痴呆症的发病率有影响。在 CKD 患者中，与非痴呆患者相比，痴呆患者发生心力衰竭的风险显着较高：OR 2.0 [95 % CI 1.7-2.4]，这对于男性 (OR 2.4 [1.8-3.1]) 和女性 (OR 2.6 [2.0-3.3]) 在任何年龄都是相同的。然而，接受透析治疗的痴呆患者的心力衰竭调整风险与无 CKD 的痴呆患者没有差异（OR 1.3 [1.0-1.6]）。痴呆显着增加透析患者的心力衰竭风险，但无论是否接受透析治疗，痴呆患者的这种风险同样高。这些结果强调痴呆是透析中心力衰竭的主要危险因素，并表明降低骨折风险应将痴呆作为危险因素。
Chronic kidney disease increases the risk of hip fractures which can be promoted by dementia. We here showed that dementia increased the risk of hip fractures in dialysis patients, but in a similar manner than without dialysis. Attention should be paid to dementia to prevent hip fractures.Hip fractures (HF) are associated with significant morbidity and is further increased in patients with chronic kidney disease (CKD). Dementia, frequent in CKD, might be a risk factor for HF. We here aimed to assess if dementia increased the risk of hip fracture in CKD.The study was derived from the French National Database of Hospitalization. Data were obtained over the period 2011-2013. Three populations of subjects > 60 years were extracted. Hip fractures, dialysis, and dementia were the main studied factors. The three populations were crossed to estimate the fracture risk based on dementia or dialysis, adjusted for age and gender. The fracture risk was calculated using a multiple logistic regression model.Over this period, 213,180 patients experienced a HF, 660,434 patients were diagnosed for dementia, and 47,430 patients were on dialysis. There was an effect of age and gender on the incidence of HF and dementia. In CKD patients, the risk of HF was significantly higher in demented patients compared to those without dementia: OR 2.0 [95 % CI 1.7-2.4], this being the same for men (OR 2.4 [1.8-3.1]) and women (OR 2.6 [2.0-3.3]) and at any age. However, the adjusted risk for HF in demented patients on dialysis therapy is not different than in demented patients without CKD (OR 1.3 [1.0-1.6]).Dementia significantly increases the risk of HF in patients on dialysis, but this risk in demented patients is equally high whether receiving dialysis therapy or not. These results highlight dementia as a major risk factor for HF in dialysis and indicate that reduction of fracture risk should include dementia as a risk factor.