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Major fractures contribute to increased mortality in dialysis patients

27 Feb 2020

Major fractures (MFs) are prevalent in dialysis patients and appear to be strongly related to heightened risk of death, a study reports.

The analysis included 9,714 incident dialysis patients (mean age, 68 years; 67 percent men). Researchers examined the incidence, predictors and clinical outcomes associated with first MFfirst (in hip, spine, humerus and forearm) occurring after initiation of dialysis using flexible parametric hazard models, Fine-Gray and time-dependent analyses.

Over a median follow-up of 2.2 years, a total of 835 MFfirst and 470 hip fractures occurred. The crude incidence rates were 23.7 and 13.3 per 1,000 patient-years, respectively. The multivariate-adjusted fracture incidence rates showed a gradual increase after dialysis initiation and were higher by 47 percent in women.

Significant factors associated with increased MFfirst risk included female sex, higher age, comorbidity and previous history of MF, whereas peritoneal dialysis (vs haemodialysis) exerted a protective effect.

The adjusted fracture incidence rate of MFfirst during the first 90 days following dialysis initiation was higher in patients with vs without previous history of MF.

MFfirst emerged as an independent predictor of increased mortality both from all-cause (sub-distribution hazard ratio [SHR], 1.67, 95 percent confidence interval [CI], 1.47–1.91) and cardiovascular disease (SHR, 1.49, 95 percent CI, 1.22–1.84).

Adjusted mortality rate was higher following hip fractures than other types of MF. Mortality following MFfirst was highest during the first 6 months of follow-up, as indicated in spline curves.

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Most Read Articles
5 days ago
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Jairia Dela Cruz, 6 days ago
Following vegan and vegetarian diets, which offer plenty of what is good for health, has been reported to have a downside: an increased risk of depression and anxiety, especially for younger adults.
Pearl Toh, 29 Jun 2020
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Roshini Claire Anthony, 3 days ago

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