Increased risk of hip fracture among Japanese hemodialysis patients
- 643 Downloads
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.
KeywordsGeneral 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.
- 6.Jadoul M, Albert JM, Akiba T, Akizawa T, Arab L, Bragg-Gresham JL, Mason N, Prutz KG, Young EW, Pisoni RL (2006) Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study. Kidney Int 70:1358–1366PubMedCrossRefGoogle Scholar
- 14.Morris JA, Gardner MJ (2000) Epidemiological studies. In: Altman DG, Machin D, Bryant TN, Gardner MJ (eds) Statistics with confidence, 2nd edn. BMJ Books, London, pp 57–72Google Scholar
- 22.Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group (2009) KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl 113:S1–130Google Scholar