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01-05-2018 | Original Article

The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study

Authors: J. Przedlacki, J. Buczyńska-Chyl, P. Koźmiński, E. Niemczyk, E. Wojtaszek, E. Gieglis, P. Żebrowski, A. Podgórzak, J. Wściślak, M. Wieliczko, J. Matuszkiewicz-Rowińska, Mazovia Fracture Study Group

Published in: Osteoporosis International | Issue 5/2018

Abstract

Summary

We assessed the FRAX® method in 718 hemodialyzed patients in estimating increased risk of bone major and hip fractures. Over two prospective years, statistical analysis showed that FRAX® enables a better assessment of bone major fracture risk in these patients than any of its components and other risk factors considered in the analysis.

Introduction

Despite the generally increased risk of bone fractures among patients with end-stage renal disease, no prediction models for identifying individuals at particular risk have been developed to date. The goal of this prospective, multicenter observational study was to assess the usefulness of the FRAX® method in comparison to all its elements considered separately, selected factors associated with renal disease and the history of falls, in estimating increased risk of low-energy major bone and hip fractures in patients undergoing chronic hemodialysis.

Methods

The study included a total of 1068 hemodialysis patients, who were followed for 2 years, and finally, 718 of them were analyzed. The risk analysis included the Polish version of the FRAX® calculator (without bone mineral density), dialysis vintage, mineral metabolism disorders (serum calcium, phosphate, and parathyroid hormone), and the number of falls during the last year before the study.

Results

Over 2 years, low-energy 30 major bone fractures were diagnosed and 13 of hip fractures among them. Area under the curve for FRAX® was 0.76 (95% CI 0.69–0.84) for major fractures and 0.70 (95% CI 0.563–0.832) for hip fractures. The AUC for major bone fractures was significantly higher than for all elements of the FRAX® calculator. In logistic regression analysis FRAX® was the strongest independent risk factor of assessment of the major bone fracture risk.

Conclusions

FRAX® enables a better assessment of major bone fracture risk in ESRD patients undergoing hemodialysis than any of its components and other risk factors considered in the analysis.

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Title: The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study
Authors: J. Przedlacki
J. Buczyńska-Chyl
P. Koźmiński
E. Niemczyk
E. Wojtaszek
E. Gieglis
P. Żebrowski
A. Podgórzak
J. Wściślak
M. Wieliczko
J. Matuszkiewicz-Rowińska
Mazovia Fracture Study Group
Publication date: 01-05-2018
Publisher: Springer London
Published in: Osteoporosis International / Issue 5/2018
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI: https://doi.org/10.1007/s00198-018-4406-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The utility of FRAX® in predicting bone fractures in patients with chronic kidney disease on hemodialysis: a two-year prospective multicenter cohort study

Abstract

Summary

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusions

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