Osteoporosis International

, Volume 19, Issue 11, pp 1549–1556

Renal function and rate of hip bone loss in older men: the Osteoporotic Fractures in Men Study

  • A. Ishani
  • M. Paudel
  • B. C. Taylor
  • E. Barrett-Connor
  • S. Jamal
  • M. Canales
  • M. Steffes
  • H. A. Fink
  • E. Orwoll
  • S. R. Cummings
  • K. E. Ensrud
  • for the Osteoporotic Fractures in Men (MrOS) Study Group
Original Paper
  • 237 Downloads

Abstract

Summary

Older men with reduced renal function are at increased risk of hip bone loss. Given the robustness of this association across different measures and a growing body of literature, our findings indicate that clinicians should take into account renal function when evaluating older men for osteoporosis risk and bone loss. Future randomized controlled trials should test whether interventions in this high risk population are effective in preventing bone loss and decreasing fracture incidence.

Introduction

Studies examining whether kidney impairment, not requiring dialysis, is associated with osteoporosis have reported conflicting results.

Methods

We tested the hypothesis that reduced renal function in older men as manifested by higher concentrations of cystatin C or lower levels of estimated glomerular filtration rate (eGFR) is associated with higher rates of bone loss. We measured serum cystatin C, serum creatinine and total hip bone mineral density (BMD) at baseline in a cohort of 404 older men enrolled in the Osteoporotic Fractures in Men (MrOS) Study and followed them prospectively for an average of 4.4 years for changes in BMD. Associations between renal function and change in hip BMD were examined using linear regression.

Results

In multivariable analysis, the mean rate of decline in total hip BMD showed an increase in magnitude with higher cystatin C concentration (mean annualized percent change −0.29, −0.34, −0.37 and −0.65% for quartiles 1 to 4; p for trend=0.004). Similarly, adjusted rates of hip bone loss were higher among men with lower eGFR as defined by the modification of diet in renal disease formula (mean annualized percent change −0.58, −0.39, −0.37, and −0.31 for quartiles 1 to 4; p for trend=0.02), but not among men with lower eGFR as defined by the Cockcroft–Gault formula (mean annualized percent change −0.47, −0.44, −0.31 and −0.43 for quartiles 1 to 4; p for trend=0.48).

Conclusions

Older men with reduced renal function are at increased risk of hip bone loss. Our findings suggest that health care providers should consider renal function when evaluating older men for risk factors for bone loss and osteoporosis.

Keywords

Chronic kidney disease Cystatin C Glomerular filtration rate Osteoporosis Population studies 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2008

Authors and Affiliations

  • A. Ishani
    • 1
    • 2
    • 9
  • M. Paudel
    • 1
  • B. C. Taylor
    • 1
    • 2
  • E. Barrett-Connor
    • 4
  • S. Jamal
    • 5
  • M. Canales
    • 2
  • M. Steffes
    • 3
  • H. A. Fink
    • 1
    • 2
    • 8
  • E. Orwoll
    • 6
  • S. R. Cummings
    • 7
  • K. E. Ensrud
    • 1
    • 2
  • for the Osteoporotic Fractures in Men (MrOS) Study Group
  1. 1.Center for Chronic Disease Outcomes ResearchVeterans Affairs Medical CenterMinneapolisUSA
  2. 2.Departments of MedicineUniversity of MinnesotaMinneapolisUSA
  3. 3.Laboratory Medicine and PathologyUniversity of MinnesotaMinneapolisUSA
  4. 4.Division of Epidemiology, Department of Family and Preventative MedicineUniversity of CaliforniaSan DiegoUSA
  5. 5.Division of EndocrinologySt. Michael’s Hospital and University of TorontoTorontoCanada
  6. 6.Oregon Health Sciences UniversityPortlandUSA
  7. 7.California Pacific Medical Center Research InstituteSan FranciscoUSA
  8. 8.Geriatric Research Education and Clinical CenterVeterans Affairs Medical CenterMinneapolisUSA
  9. 9.MinneapolisUSA

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