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المؤلفون: Tariq E. Farrah, Jamie P. Traynor, Sue Robertson, Vishal Dey, Colin C. Geddes, Elaine Spalding
المصدر: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 32(7)
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Population, 030232 urology & nephrology, urologic and male genital diseases, Peritoneal dialysis, 03 medical and health sciences, chemistry.chemical_compound, Fractures, Bone, Young Adult, 0302 clinical medicine, Renal Dialysis, Risk Factors, Internal medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, Renal replacement therapy, Prospective Studies, education, Kidney transplantation, Aged, Retrospective Studies, Transplantation, education.field_of_study, Bone Density Conservation Agents, business.industry, Hydroxycholecalciferols, Alfacalcidol, Bone fracture, Middle Aged, medicine.disease, Surgery, Renal Replacement Therapy, chemistry, Scotland, Nephrology, Kidney Failure, Chronic, Female, Hemodialysis, business
الوصف: Background Bone fractures are an important cause of morbidity and mortality in patients on renal replacement therapy (RRT). The aim of this multicentre observational study was to quantify the incidence of radiologically proven bone fracture by anatomical site in prevalent RRT groups and study its relationship to potential risk factors. Methods We performed a retrospective analysis of electronic records of all 2096 adults prevalent on RRT in the West of Scotland on 7 July 2010 across all hospitals (except one where inception was 1 August 2011) to identify all subsequent radiologically proven fractures during a median 3-year follow-up. Results There were 340 fractures, with an incidence of 62.8 per 1000 patient-years. The incidences were 37.6, 99.2 and 57.6 per 1000 patient-years in the transplant, haemodialysis (HD) and peritoneal dialysis (PD) groups, respectively (P < 0.05). In the multivariable model, age and HD (relative to transplant or PD) were independently associated with increased risk of fractures, while primary glomerular disease, increasing serum albumin and taking alfacalcidol or lanthanum were associated with decreased risk. In a multivariable model of only HD patients, age was independently associated with an increased risk of fractures, while glomerular disease, high serum albumin and being on alfacalcidol and lanthanum were associated with decreased risk. In a multivariable model in transplant patients, there were no significant independent predictors of fracture. Conclusions The risk of symptomatic bone fracture is high in RRT patients and is ∼2.5 times higher in HD than in renal transplant patients, with the increased risk being independent of baseline factors. Fracture risk increases with age and lower serum albumin and is reduced if the primary renal diagnosis is glomerular disease. The possible protective role of alfacalcidol and lanthanum in HD patients deserves further exploration.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8f5b91f34a13d3ee2da7ba11c88f0e2e
https://pubmed.ncbi.nlm.nih.gov/27257273