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Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis

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Abstract

Summary

We assessed in a cross-sectional study in elderly men and women with osteoporosis, the association between the creatinine clearance (CrCl) and the performance in different balance and muscle power and function tests and found that a decreasing creatinine clearance was significantly associated with lower balance and muscle power.

Introduction

To determine if a creatinine clearance of <65 ml/min is significantly associated with decreasing muscle power and balance and an increased risk for falls and fractures.

Methods

We assessed in a cross-sectional-study in 1781 German osteoporotic patients, the association between the CrCl, the physical performance, and the number of falls and fractures.

Results

Controlling for age, gender, BMI, and osteoporosis treatment (fracture analysis only), a decreasing CrCl was associated with lower physical performance in the timed-up-and-go test (corr −0.2337, P < 0.0001), chair-rising test (corr −0.1706, P < 0.001), and tandem-stand test (corr 0.2193, P < 0.0001), and a CrCl of <65 ml/min was associated with a significantly higher risk for falls (47.7% vs. 36.2%, P = 0.0008) and fall-related fractures (33.1% vs. 22.9%, P = 0.0003) compared with a CrCl of ≥65 ml/min.

Conclusions

In this study, we found a significant gender-independent correlation between decreasing CrCl and lower performance in balance and muscle power tests. Reduced muscle power and balance may therefore be involved in the low creatinine clearance associated increased risk for falls and fall-related fractures. Furthermore, we found that a CrCl <65 ml/min., independent from the performance in muscle power, muscle function, and balance tests, is a significant risk factor for falls and fractures.

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Acknowledgement

We are indebted to Manfred Klasser, auditor and GWD consult, for his precise and meticulous monitoring.

Conflicts of interest

This study was supported by TEVA Pharmaceuticals Industries Ltd., Israel.

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Authors and Affiliations

  1. Department of Medicine, Acute Geriatric University Clinic, Basel, Switzerland

    L. Dukas

  2. Ambulatorium Wiesendamm, Wiesendamm 22, 4057, Basel, Switzerland

    L. Dukas

  3. Zürich Osteoporosis Research Group ZORG, Zollikerberg, Switzerland

    E. Schacht

  4. Aerpah Clinic Esslingen, Esslingen, Germany

    M. Runge

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  1. L. Dukas
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  2. E. Schacht
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  3. M. Runge
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Correspondence to L. Dukas.

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Dukas, L., Schacht, E. & Runge, M. Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis. Osteoporos Int 21, 1237–1245 (2010). https://doi.org/10.1007/s00198-009-1064-1

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