Osteoporosis International

, Volume 16, Issue 12, pp 1683–1690 | Cite as

In elderly men and women treated for osteoporosis a low creatinine clearance of <65 ml/min is a risk factor for falls and fractures

  • Laurent DukasEmail author
  • Erich Schacht
  • Hannes B. Stähelin
Original Article


Recently, a low creatinine clearance (CrCl) of <65 ml/min was described as a new significant and independent risk factor for the number of fallers and falls in a community-dwelling elderly population. In this study we investigated if a low creatinine clearance of <65 ml/min is also a risk factor for falls and fractures in elderly men and women treated for osteoporosis. In a cross-sectional study with the help of questionnaires we assessed the prevalence of having experienced falls within the last 12 months according to renal function in 5,313 German men and women receiving treatment for osteoporosis. The CrCl was calculated using the established Cockcroft-Gault formula. The prevalence of falls and fractures was assessed in multivariate-controlled logistic regression models according to a CrCl cut off of 65 ml/min. The P -values were two-sided. In this study of elderly men and women treated for osteoporosis ( n =5,313), 60.9% ( n =3,238) had a CrCl of <65 ml/min, which was associated in multivariate controlled analyses, compared to a CrCl of ≥65 ml/min ( n =2,075), with a significant increased risk of experiencing falls (1,775/3,238 vs. 773/2,075, OR 1.69, 95% CI 1.50–1.91, P <0.0001) and an increased risk for multiple falls (37.1 vs. 22.6%, OR 1.63, 95% CI 1.42–1.87, P <0.0001). Furthermore, compared to a creatinine clearance of ≥65 ml/min, a creatinine clearance of <65 ml/min was also associated with a significant increased multivariate controlled risk for hip fractures (OR 1.57, 95%CI 1.18–2.09, P =0.002), for radial fractures (OR 1.79, 95%CI 1.39–2.31, P =<0.0001), for total vertebral fractures (OR 1.31, 95%CI 1.19–1.55, P =0.003) and for fall-associated vertebral fractures (OR 1.24, 95% CI 1.03–1.54, P =0.031). Similar to community-dwelling elderly, in elderly men and women treated for osteoporosis a CrCl of less than 65 ml/min is a significant and independent risk factor for falls. Furthermore, we could show for the first time that a low creatinine clearance in elderly men and women treated for osteoporosis is also associated with a significantly increased risk of vertebral, hip and radial fractures.


Creatinine clearance Osteoporosis treatment Falls Fractures 



The study was supported by GRY Pharma GmbH, Germany.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2005

Authors and Affiliations

  • Laurent Dukas
    • 1
    • 3
    Email author
  • Erich Schacht
    • 2
  • Hannes B. Stähelin
    • 1
  1. 1.Geriatric University ClinicKantonsspitalBaselSwitzerland
  2. 2.Department of Rheumatology and RehabilitationUniversity Clinic BalgristZurichSwitzerland
  3. 3.Acute Geriatric University Clinic and Ambulatorium WiesendammBaselSwitzerland

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