Relationship between moderate to severe kidney disease and hip fracture in the United States
Relationship between moderate to severe kidney disease and hip fracture in the United States
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DOI：
10.1681/asn.2005111194
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发表时间：
2006-11-01
影响因子：
13.6
通讯作者：
Shane, Elizabeth
中科院分区：
文献类型：
--
作者：
Nickolas, Thomas L.;McMahon, Donald J.;Shane, Elizabeth
患有ESRD的人患髋部骨折的风险很高。然而，中到重度慢性肾脏病(CKD)对髋部骨折风险的影响还没有得到很好的研究。作为第三次国民健康和营养检查调查的一部分，获得了有关肾功能和髋部骨折病史的信息。这项调查是一项复杂的、多阶段的、对美国非制度化平民人口的概率抽样，是在1988年至1994年间进行的。通过对所有参与者的问卷调查的回答来确定髋部骨折的病史。髋部骨折159例。在GFR和60毫升/分钟(优势比[OR]2.12；95%可信区间[CI]1.18至3.80)的参与者中，报告髋部骨折的可能性显著增加。在较年轻的参与者(50岁至74岁)中，有髋部骨折病史的CKD患病率大约是无髋部骨折病史的患者的三倍(分别为19.0和6.2%；P=0.04)。在多因素Logistic回归分析中，只有CKD的存在(OR 2.32；95%CI 1.13~4.74)、骨质疏松病史(OR 2.52；95%CI 1.08~5.91)和低体力活动水平(OR 2.10；95%CI 1.03~4.27)与髋部骨折史相关。髋部骨折与中度至重度慢性肾脏病之间有显著的相关性，特别是在年轻个体中，这与髋部骨折的传统危险因素无关。
People with ESRD are at a high risk for hip fracture. However, the effect of moderate to severe chronic kidney disease (CKD) on hip fracture risk has not been well studied. As part of the Third National Health and Nutrition Examination Survey, information on both kidney function and history of hip fracture was obtained. This survey is a complex, multistage, probability sample of the US noninstitutionalized civilian population and was conducted between 1988 and 1994. A history of hip fracture was identified from the response to a questionnaire that was administered to all participants. There were 159 cases of hip fracture. There was a significantly increased likelihood of reporting a hip fracture in participants with estimated GFR < 60 ml/min (odds ratio [OR] 2.12; 95% confidence interval [CI] 1.18 to 3.80). In younger participants (aged 50 to 74 yr), the prevalence of CKD was approximately three-fold higher in those with a history of hip fracture versus in those without a history of hip fracture (19.0 versus 6.2%, respectively; P = 0.04). In multivariate logistic regression analysis, only the presence of CKD (OR 2.32; 95% CI 1.13 to 4.74), a reported history of osteoporosis (OR 2.52; 95% CI 1.08 to 5.91), and low physical activity levels (OR 2.10; 95% CI 1.03 to 4.27) were associated with a history of hip fracture. There is a significant association between hip fracture and moderate to severe degrees of CKD, particularly in younger individuals, that is independent of traditional risk factors for hip fracture.