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Bone mineral density and fracture risk in older individuals with CKD

Yenchek, RH and Ix, JH and Shlipak, MG and Bauer, DC and Rianon, NJ and Kritchevsky, SB and Harris, TB and Newman, AB and Cauley, JA and Fried, LF (2012) Bone mineral density and fracture risk in older individuals with CKD. Clinical Journal of the American Society of Nephrology, 7 (7). 1130 - 1136. ISSN 1555-9041

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Abstract

Background and objectives Kidney Disease Improving Global Outcomes guidelines recommend against bone mineral density (BMD) screening in CKD patients withmineral bone disease, due to a lack of association of BMD with fractures in cross-sectional studies in CKD. We assessed whether BMD is associated with fractures in participants with and without CKD in the Health, Aging, and Body Composition study, a prospective study of well functioning older individuals. Design, setting, participants, & measurements Hip BMD was measured by dual-energy x-ray absorptiometry. Osteoporosis was defined as a femoral neck BMD (FNBMD) T score below 22.5 and CKD as an estimated GFR, 60ml/min per 1.73m 2. The association of BMDwith incident nonspine, fragility fractures to study year 11was analyzed using Cox proportional hazards analyses, adjusting for age, race, sex, body mass index, hyperparathyroidism, low vitaminDlevel, and CKD. Interaction termswere used to assesswhether the association of BMD with fracture differed in those with and without CKD. Results There were 384 incident fractures in 2754 individuals (mean age 73.6 years). Lower FNBMD was associated with greater fracture, regardless of CKD status. After adjustment, the hazard ratios (95% confidence intervals) were 2.74 (1.99, 3.77) and 2.15 (1.80, 2.57) per lower SD FNBMD for those with and without CKD, respectively (interaction P=0.68), and 2.10 (1.23, 3.59) and 1.63 (1.18, 2.23) among those with osteoporosis in patients with and without CKD, respectively (interaction P=0.75). Conclusions BMD provides information on risk for fracture in older individuals with or without moderate CKD. © 2012 by the American Society of Nephrology.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Yenchek, RH
Ix, JH
Shlipak, MG
Bauer, DC
Rianon, NJ
Kritchevsky, SB
Harris, TB
Newman, ABANEWMAN@pitt.eduANEWMAN
Cauley, JAJCauley@edc.pitt.eduJCAULEY
Fried, LFlff9@pitt.eduLFF9
Date: 1 July 2012
Date Type: Publication
Journal or Publication Title: Clinical Journal of the American Society of Nephrology
Volume: 7
Number: 7
Page Range: 1130 - 1136
DOI or Unique Handle: 10.2215/cjn.12871211
Schools and Programs: Graduate School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1555-9041
Date Deposited: 03 Apr 2015 00:41
Last Modified: 22 May 2019 12:55
URI: http://d-scholarship.pitt.edu/id/eprint/24251

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