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Osteoporosis International
Published in: Osteoporosis International 4/2020

01-04-2020 | Osteoporosis | Original Article

Chronic kidney disease–related osteoporosis is associated with incident frailty among patients with diabetic kidney disease: a propensity score–matched cohort study

Authors: C.-T. Chao, J. Wang, J.-W. Huang, D.-C. Chan, K.-Y. Hung, K.-L. Chien, on behalf of the COhort of GEriatric Nephrology in NTUH (COGENT) study group

Published in: Osteoporosis International | Issue 4/2020

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Abstract

Summary

Chronic kidney disease (CKD)-related osteoporosis is a major complication in patients with CKD, conferring a higher risk of adverse outcomes. We found that among those with diabetic kidney disease, this complication increased the risk of incident frailty, an important mediator of adverse outcomes.

Introduction

Renal osteodystrophy and chronic kidney disease (CKD)-related osteoporosis increases complications for patients with diabetic kidney disease (DKD). Since musculoskeletal degeneration is central to frailty development, we investigated the relationship between baseline osteoporosis and the subsequent frailty risk in patients with DKD.

Methods

From the Longitudinal Cohort of Diabetes Patients in Taiwan (n = 840,000), we identified 12,027 patients having DKD with osteoporosis and 24,054 propensity score-matched controls having DKD but without osteoporosis. The primary endpoint was incident frailty on the basis of a modified FRAIL scale. Patients were prospectively followed-up until the development of endpoints or the end of this study. The Kaplan-Meier technique and Cox proportional hazard regression were used to analyze the association between osteoporosis at baseline and incident frailty in these patients.

Results

The mean age of the DKD patients was 67.2 years, with 55.4% female and a 12.6% prevalence of osteoporosis at baseline. After 3.5 ± 2.2 years of follow up, the incidence rate of frailty in patients having DKD with osteoporosis was higher than that in DKD patients without (6.6 vs. 5.7 per 1000 patient-year, p = 0.04). A Cox proportional hazard regression showed that after accounting for age, gender, obesity, comorbidities, and medications, patients having DKD with osteoporosis had a significantly higher risk of developing frailty (hazard ratio, 1.19; 95% confidence interval, 1.02–1.38) than those without osteoporosis.

Conclusions

CKD-related osteoporosis is associated with a higher risk of incident frailty in patients with DKD.
Appendix
Available only for authorised users
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Metadata
Title
Chronic kidney disease–related osteoporosis is associated with incident frailty among patients with diabetic kidney disease: a propensity score–matched cohort study
Authors
C.-T. Chao
J. Wang
J.-W. Huang
D.-C. Chan
K.-Y. Hung
K.-L. Chien
on behalf of the COhort of GEriatric Nephrology in NTUH (COGENT) study group
Publication date
01-04-2020
Publisher
Springer London
Published in
Osteoporosis International / Issue 4/2020
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-020-05353-9

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