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Fracture risk in chronic kidney disease: A Korean population-based cohort study

Title
Fracture risk in chronic kidney disease: A Korean population-based cohort study
Author
권영은
Keywords
Chronic renal insufficiency; Dialysis; Fracture; Phosphate binder
Issue Date
2019-06
Publisher
KOREAN SOC NEPHROLOGY
Citation
KIDNEY RESEARCH AND CLINICAL PRACTICE, v. 38, no. 2, page. 220-228
Abstract
Background: Chronic kidney disease (CKD)-mineral and bone disorder (MBD) and fracture risk are both closely related to declining renal function. Controlling hyperphosphatemia with phosphate binders is a basic principle of CKD-MBD treatment. The aim of this study was to identify differences in fracture risk between pre-dialysis CKD patients and end-stage renal disease (ESRD) on dialysis, and to evaluate the effects of phosphate binders on fracture risk in ESRD patients. Methods: Data from a total of 89,533 CKD patients comprising CKD diagnosis, dialysis, fracture history, and phosphate binder prescription history from 2012 to 2016 were retrieved from the Health Insurance Review and Assessment Service Database. Multivariate Cox regression analyses were performed to identify whether dialysis or phosphate binders were associated with an increased fracture risk. Results: Overall, the rate of fractures in pre-dialysis CKD patients was 74 per 1,000 patient-years, while that in dialysis patients was 84 per 1,000 patient-years. The risk of fracture in ESRD patients was higher than pre-dialysis CKD patients (hazard ratio, 1.16; 95% confidence interval, 1.12-1.21; P < 0.001) after adjusting for confounding variables. In addition, the fracture risk in patients who were not taking phosphate binders was 20.0% higher compared to ESRD patients taking phosphate binders. Conclusion: Fractures were more prevalent in ESRD patients on dialysis than pre-dialysis CKD patients. Use of phosphate binders was associated with a lower fracture risk in ESRD patients.
URI
https://www.krcp-ksn.org/journal/view.php?doi=10.23876/j.krcp.18.0099https://repository.hanyang.ac.kr/handle/20.500.11754/162792
ISSN
2211-9132; 2211-9140
DOI
10.23876/j.krcp.18.0099
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COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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