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Incidence of bone fractures among patients on maintenance hemodialysis

BACKGROUND: Patients with chronic kidney disease, especially those undergoing hemodialysis (HD), have a higher risk of fragility fractures. However, the magnitude of the problem and risk factors associated with fracture incidence have not been well studied in the Kingdom of Saudi Arabia. METHODS: Th...

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Autores principales: Kashgary, Abdullah, Attiah, Feryal Omar A., AlKhateeb, Nada AbuBakr, Abdulaziz, Nada H., Alsaif, Banan Abdullah, Aljuhani, Amal Fahad, Abdalbary, Mohamed, Nagy, Eman, Abdelsalam, Mostafa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288917/
https://www.ncbi.nlm.nih.gov/pubmed/37345711
http://dx.doi.org/10.1080/0886022X.2023.2224456
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author Kashgary, Abdullah
Attiah, Feryal Omar A.
AlKhateeb, Nada AbuBakr
Abdulaziz, Nada H.
Alsaif, Banan Abdullah
Aljuhani, Amal Fahad
Abdalbary, Mohamed
Nagy, Eman
Abdelsalam, Mostafa
author_facet Kashgary, Abdullah
Attiah, Feryal Omar A.
AlKhateeb, Nada AbuBakr
Abdulaziz, Nada H.
Alsaif, Banan Abdullah
Aljuhani, Amal Fahad
Abdalbary, Mohamed
Nagy, Eman
Abdelsalam, Mostafa
author_sort Kashgary, Abdullah
collection PubMed
description BACKGROUND: Patients with chronic kidney disease, especially those undergoing hemodialysis (HD), have a higher risk of fragility fractures. However, the magnitude of the problem and risk factors associated with fracture incidence have not been well studied in the Kingdom of Saudi Arabia. METHODS: This multicenter retrospective study involved HD centers in Jeddah from 2015 to 2021. This study included all adult HD patients. Patient demographics, medication usage, and clinical and biochemical parameters were collected from the registry records. RESULTS: The study included 328 patients on HD, with a mean age of 53 years. The median duration of HD was 47 months. Osteoporosis was found in 9% of the patients, and 8% had a previous parathyroidectomy. Over the observation period, fractures occurred in 32 patients, with an incidence rate of 20 case/1000 end stage kidney disease patients-year. Patients with fractures had a higher rate of osteoporosis, underwent more parathyroidectomy, had longer HD vintage, and higher bone-specific alkaline phosphatase (BSAP) levels. BSAP was the most significant predictor of fracture incidence in the regression analysis. Using a BSAP cutoff value of 96.6 µg/L, the sensitivity and specificity to predict fractures were 81.8% and 49%, respectively. CONCLUSION: The main risk factors for incident fractures were osteoporosis, previous parathyroidectomy, longer HD vintage, and higher BSAP level. A higher BSAP score was the most significant predictor of incident fractures. This may highlight the importance of monitoring bone turnover markers and the negative impact of high bone turnover on patient health.
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spelling pubmed-102889172023-06-24 Incidence of bone fractures among patients on maintenance hemodialysis Kashgary, Abdullah Attiah, Feryal Omar A. AlKhateeb, Nada AbuBakr Abdulaziz, Nada H. Alsaif, Banan Abdullah Aljuhani, Amal Fahad Abdalbary, Mohamed Nagy, Eman Abdelsalam, Mostafa Ren Fail Clinical Study BACKGROUND: Patients with chronic kidney disease, especially those undergoing hemodialysis (HD), have a higher risk of fragility fractures. However, the magnitude of the problem and risk factors associated with fracture incidence have not been well studied in the Kingdom of Saudi Arabia. METHODS: This multicenter retrospective study involved HD centers in Jeddah from 2015 to 2021. This study included all adult HD patients. Patient demographics, medication usage, and clinical and biochemical parameters were collected from the registry records. RESULTS: The study included 328 patients on HD, with a mean age of 53 years. The median duration of HD was 47 months. Osteoporosis was found in 9% of the patients, and 8% had a previous parathyroidectomy. Over the observation period, fractures occurred in 32 patients, with an incidence rate of 20 case/1000 end stage kidney disease patients-year. Patients with fractures had a higher rate of osteoporosis, underwent more parathyroidectomy, had longer HD vintage, and higher bone-specific alkaline phosphatase (BSAP) levels. BSAP was the most significant predictor of fracture incidence in the regression analysis. Using a BSAP cutoff value of 96.6 µg/L, the sensitivity and specificity to predict fractures were 81.8% and 49%, respectively. CONCLUSION: The main risk factors for incident fractures were osteoporosis, previous parathyroidectomy, longer HD vintage, and higher BSAP level. A higher BSAP score was the most significant predictor of incident fractures. This may highlight the importance of monitoring bone turnover markers and the negative impact of high bone turnover on patient health. Taylor & Francis 2023-06-22 /pmc/articles/PMC10288917/ /pubmed/37345711 http://dx.doi.org/10.1080/0886022X.2023.2224456 Text en © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
spellingShingle Clinical Study
Kashgary, Abdullah
Attiah, Feryal Omar A.
AlKhateeb, Nada AbuBakr
Abdulaziz, Nada H.
Alsaif, Banan Abdullah
Aljuhani, Amal Fahad
Abdalbary, Mohamed
Nagy, Eman
Abdelsalam, Mostafa
Incidence of bone fractures among patients on maintenance hemodialysis
title Incidence of bone fractures among patients on maintenance hemodialysis
title_full Incidence of bone fractures among patients on maintenance hemodialysis
title_fullStr Incidence of bone fractures among patients on maintenance hemodialysis
title_full_unstemmed Incidence of bone fractures among patients on maintenance hemodialysis
title_short Incidence of bone fractures among patients on maintenance hemodialysis
title_sort incidence of bone fractures among patients on maintenance hemodialysis
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10288917/
https://www.ncbi.nlm.nih.gov/pubmed/37345711
http://dx.doi.org/10.1080/0886022X.2023.2224456
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