Journal of Bone and Mineral Metabolism

, Volume 31, Issue 3, pp 315–321 | Cite as

Increased risk of hip fracture among Japanese hemodialysis patients

  • Minako Wakasugi
  • Junichiro James Kazama
  • Masatomo Taniguchi
  • Atsushi Wada
  • Kunitoshi Iseki
  • Yoshiharu Tsubakihara
  • Ichiei Narita
Original Article


Incidence of hip fracture in dialysis patients is significantly higher than that in the general population. As information is lacking about Asian dialysis patients, we compared the incidence of hip fracture in hemodialysis patients with that in the general population in Japan. We conducted a retrospective cohort study using panel data from the Japanese Society for Dialysis Therapy registry. The study included patients without history of hip fracture who received hemodialysis three times per week as of December 31, 2007. We compared the observed number of hip fractures to the expected number derived from a national survey, and calculated standardized incidence ratios (SIRs) and the incidence rate difference. Subgroup analysis was performed according to vintage and diabetic status. During the one-year study period, 1,437 hip fractures were recorded in the 128,141 hemodialysis patients (61.9 % male). The overall incidence was 7.57 and 17.43 per 1,000 person-years in men and women, respectively. The SIRs for male and female patients were 6.2 [95 % confidence interval (CI) 5.7–6.8] and 4.9 (95 % CI 4.6–5.3) compared to the general population, and remained nearly constant until 16 years vintage, but increased steeply thereafter. The incidence rate difference of hip fracture increased with age. The SIRs for diabetics of both genders were higher than those for non-diabetics. Our study provides additional evidence that hip fracture risk among Asian dialysis patients is also significantly higher than in the general population.


General population Hemodialysis Hip fracture Standardized incidence ratio 



These data were presented in part at the annual meeting of the American Society of Nephrology, December 15–19, 2011, Philadelphia, PA. Data were obtained with the permission of the Committee of Renal Data Registry of the Japanese Society for Dialysis Therapy. We used the standard analysis file (JRDR-09001) for this study. The opinions reflected in this manuscript are those of the authors alone and do not reflect an official position of the Japanese Society for Dialysis Therapy. This study was supported in part by a Grant-in-Aid for Progressive Renal Diseases Research, Research on Intractable Disease, from the Ministry of Health, Labor, and Welfare of Japan.

Conflict of interest

The authors have no conflicts of interest to declare.


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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013

Authors and Affiliations

  • Minako Wakasugi
    • 1
  • Junichiro James Kazama
    • 2
  • Masatomo Taniguchi
    • 3
  • Atsushi Wada
    • 3
  • Kunitoshi Iseki
    • 3
  • Yoshiharu Tsubakihara
    • 3
  • Ichiei Narita
    • 4
  1. 1.Center for Inter-organ Communication ResearchNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Division of Blood Purification TherapyNiigata University Medical and Dental HospitalNiigataJapan
  3. 3.Renal Data Registry Committee, Japanese Society for Dialysis TherapyTokyoJapan
  4. 4.Division of Clinical Nephrology and RheumatologyNiigata University Graduate School of Medical and Dental ScienceNiigataJapan

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