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International Urology and Nephrology

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01-09-2018 | Nephrology - Original Paper

Predictors of bone fractures in a single-centre cohort of hemodialysis patients: a 2-year follow-up study

Authors: Ludmila Brunerová, Renata Lažanská, Petr Kasalický, Jana Verešová, Jana Potočková, Alena Fialová, Ivan Rychlík

Published in: International Urology and Nephrology | Issue 9/2018

Abstract

Purpose

Bone involvement represents one of the complications of end-stage chronic kidney disease, with fractures being its major risk. The aim of our study was to assess the frequency and predictors of low-trauma fractures in a cohort of maintenance hemodialysis patients followed-up on for 2 years.

Methods

59 patients (67.6 ± 13.1 years, 43 males) treated with hemodiafiltration underwent initially laboratory (markers of calcium–phosphate metabolism and bone turnover markers) and densitometry examination with TBS assessment (Lunar Prodigy, TBS software 2.1.2). During 24-month follow-up, the frequency of low-trauma fractures was assessed and possible predictors of increased fracture risk were identified using product–moment correlation matrices.

Results

Altogether 7 (11.9%) low-trauma fractures were observed. In the whole group, age (P = 0.047), T-score in proximal femur (P = 0.04), low vitamin D, low BMI (P = 0.03 for both), and higher FRAX for major osteoporotic fracture (P = 0.01) were connected with fractures, but in multi-variate analysis only BMI remained significantly negatively associated with fractures (P = 0.047). TBS and bone turnover markers failed to predict fractures. However, women with fractures had significantly lower serum phosphate (P = 0.03) and higher parathyroid hormone (P = 0.04). Parameters of hip structure analysis significantly correlated with FRAX, but not with fractures.

Conclusions

In a group of hemodialysis patients from one centre, T-score in proximal femur, low vitamin D, low BMI, and high FRAX for major osteoporotic fracture were associated with low-trauma fractures, however, in multi-variate analysis only low BMI remained a significant predictor of fracture risk.

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Title: Predictors of bone fractures in a single-centre cohort of hemodialysis patients: a 2-year follow-up study
Authors: Ludmila Brunerová
Renata Lažanská
Petr Kasalický
Jana Verešová
Jana Potočková
Alena Fialová
Ivan Rychlík
Publication date: 01-09-2018
Publisher: Springer Netherlands
Published in: International Urology and Nephrology / Issue 9/2018
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-018-1958-y

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Predictors of bone fractures in a single-centre cohort of hemodialysis patients: a 2-year follow-up study

Abstract

Purpose

Methods

Results

Conclusions

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Abstract

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