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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
Authors
Kwon Y.E.Choi H.Y.Kim S.Ryu D.-R.Oh H.J.ESRD Registry Committee of the Korean Society of Nephrology
Ewha Authors
류동열오형중
SCOPUS Author ID
류동열scopus; 오형중scopus
Issue Date
2019
Journal Title
Kidney Research and Clinical Practice
ISSN
2211-9132JCR Link
Citation
Kidney Research and Clinical Practice vol. 38, no. 2, pp. 220 - 228
Keywords
Chronic renal insufficiencyDialysisFracturePhosphate binder
Publisher
The Korean Society of Nephrology
Indexed
SCOPUS; KCI scopus
Document Type
Article
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 CKDMBD treatment. The aim of this study was to identify differences in fracture risk between pre-dialysis CKD patientsand 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. © 2019 by The Korean Society of Nephrology. All rights reserved.
DOI
10.23876/j.krcp.18.0099
Appears in Collections:
의과대학 > 의학과 > Journal papers
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