Increased risk of hip fracture among men with CKD
Increased risk of hip fracture among men with CKD
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DOI：
10.1053/j.ajkd.2007.08.019
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发表时间：
2008-01-01
影响因子：
13.2
通讯作者：
Kestenbaum, Bryan
中科院分区：
文献类型：
--
作者：
Dooley, Annemarie C.;Weiss, Noel S.;Kestenbaum, Bryan
背景：慢性肾脏病（CKD）患者存在矿物质代谢紊乱。那些需要透析治疗的人骨折的风险大大增加。研究设计：回顾性队列研究。背景和参与者：我们确定了1999年7月至2006年3月在西北部的8个退伍军人事务医疗中心寻求治疗的男性，他们的肾小球滤过率（GFR）低于60 mL/min/1.73 m2。排除接受长期透析治疗或既往接受过器官移植、诊断为癌症或有髋部骨折史的患者。比例风险模型用于估计GFR分期与髋部骨折相对风险的相关性。预测因子：GFR根据6个月期间2个或2个以上连续异常门诊患者血清肌酐测量值进行估计。结果：从患者病历中确定髋部骨折。结果：在33，091名退伍军人中，确定了176例髋部骨折。在校正年龄、体重指数、糖尿病和所选药物的使用后，GFR为30 - 59和15 - 29 mL/min/1.73 m2的男性髋部骨折的相对危险度为1.28（95%置信区间，0.88至1.66）和3.98（95%可信区间，2.25 ~ 7.74）。局限性：仅对男性进行回顾性研究。结论：这些结果表明，CKD 4期男性髋部骨折的风险增加到与透析患者相似的程度。
Background: Patients with chronic kidney disease (CKD) have disturbances in mineral metabolism. Those requiring dialysis therapy are at substantially increased risk of fracture. However, fracture risk in patients with CKD not requiring dialysis has not been well studied.Study Design: Retrospective cohort.Setting & Participants: We identified men who sought care at 8 Veterans Affairs Medical Centers located in the Northwest from July 1999 to March 2006 who had a glomerular filtration rate (GFR) less than 60 mL/min/1.73 m(2). Patients who received long-term dialysis therapy or had a previous organ transplant, diagnosis of cancer, or history of hip fracture were excluded. Proportional hazards models were used to estimate the association of GFR stage with relative risk of hip fracture.Predictor: GFR estimated on the basis of 2 or more consecutively abnormal outpatient serum creatinine measurements during a 6-month period.Outcome: Hip fracture ascertained from patient medical records.Results: In 33,091 veterans, 176 hip fractures were identified. After adjustment for age, body mass index, diabetes, and use of selected medications, relative risks of hip fracture for men with a GFR of 30 to 59 and 15 to 29 mL/min/1.73 m(2) were 1.28 (95% confidence interval, 0.88 to 1.66) and 3.98 (95% confidence interval, 2.25 to 7.74), respectively.Limitations: Retrospective study of men only.Conclusions: These results suggest that the risk of hip fracture in men with CKD stage 4 is increased to a degree similar to that of dialysis patients.