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 This...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Renal Failure |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2224456 |
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| author | Abdullah Kashgary Feryal Omar A. Attiah Nada AbuBakr AlKhateeb Nada H. Abdulaziz Banan Abdullah Alsaif Amal Fahad Aljuhani Mohamed Abdalbary Eman Nagy Mostafa Abdelsalam |
| author_facet | Abdullah Kashgary Feryal Omar A. Attiah Nada AbuBakr AlKhateeb Nada H. Abdulaziz Banan Abdullah Alsaif Amal Fahad Aljuhani Mohamed Abdalbary Eman Nagy Mostafa Abdelsalam |
| author_sort | Abdullah Kashgary |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-47464fad11234b32a11c4e9606cc0c92 |
| institution | OA Journals |
| issn | 0886-022X 1525-6049 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj-art-47464fad11234b32a11c4e9606cc0c922025-08-20T02:28:54ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492023-12-0145110.1080/0886022X.2023.2224456Incidence of bone fractures among patients on maintenance hemodialysisAbdullah Kashgary0Feryal Omar A. Attiah1Nada AbuBakr AlKhateeb2Nada H. Abdulaziz3Banan Abdullah Alsaif4Amal Fahad Aljuhani5Mohamed Abdalbary6Eman Nagy7Mostafa Abdelsalam8Department of Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaMansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, EgyptMansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, EgyptMansoura Nephrology and Dialysis Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, EgyptBackground 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.https://www.tandfonline.com/doi/10.1080/0886022X.2023.2224456BonefractureskidneyhemodialysisCKDbone-specific alkaline phosphatase |
| spellingShingle | Abdullah Kashgary Feryal Omar A. Attiah Nada AbuBakr AlKhateeb Nada H. Abdulaziz Banan Abdullah Alsaif Amal Fahad Aljuhani Mohamed Abdalbary Eman Nagy Mostafa Abdelsalam Incidence of bone fractures among patients on maintenance hemodialysis Renal Failure Bone fractures kidney hemodialysis CKD bone-specific alkaline phosphatase |
| 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 | Bone fractures kidney hemodialysis CKD bone-specific alkaline phosphatase |
| url | https://www.tandfonline.com/doi/10.1080/0886022X.2023.2224456 |
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