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Fracture status in middle-aged individuals with early CKD: cross-sectional analysis of the CARTaGENE survey
- Source :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 30(4)
- Publication Year :
- 2018
-
Abstract
- Whether early chronic kidney disease (CKD) is associated with fracture in middle-aged adults is unclear. In a cross-sectional analysis of the CARTaGENE survey, we observed that early CKD was not associated with increased fracture, did not modify the association between calcaneal QUS and fracture, but modified the association between clinical, pharmacological parameters and fracture. The association between advanced CKD and increased fracture risk is well described. However, whether early CKD is associated with increased fractures, especially in middle-aged adults, is unclear. We aimed to assess if early CKD is associated with increased fracture status and whether early CKD status modifies the association between calcaneal quantitative ultrasound parameters, clinical, pharmacological parameters, and fractures. Cross-sectional analysis of CARTaGENE, a population-based survey of 40- to 69-year-old individuals. Individuals with CKD (stage 2, estimated glomerular filtration rate [eGFR] 60–89 ml/min/1.73 m2; stage 3, eGFR 30–59) were compared to non-CKD individuals (eGFR > 90). Fracture status (excluding face, toe, hand, and patella) was identified through a questionnaire at baseline. Calcaneal quantitative ultrasound (QUS) was measured in each participant. A total of 17,608 individuals (656 CKD stage 3; 8227 stage 2; 8725 non-CKD) were included. CKD stage 2 and 3 individuals (mean eGFR 78 and 53 ml/min/1.73 m2) were older and had more diabetes, cardiovascular disease, and hypertension. Fracture status prevalence was 14.9% in CKD stage 3, 10.8% in CKD stage 2, and 9.0% in non-CKD individuals. Fracture status prevalence was similar between CKD and non-CKD individuals when stratified by age or after adjustment for demographic and clinical parameters. QUS stiffness index was associated with fracture status in both CKD stage 3 (standardized odds ratio [sOR] = 1.525 [1.200 to 1.939] per 1 SD decrease), stage 2 (sOR = 1.415 [1.310 to 1.530]), and non-CKD individuals (sOR = 1.477 [1.361 to 1.602]). The associations between blood pressure, antihypertensive, and fracture status followed a U-shape throughout the progression of CKD. CKD stage 3 was not associated with an increase in fracture status. QUS parameters were similarly associated with fracture status in patients with and without CKD.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Cross-sectional study
Endocrinology, Diabetes and Metabolism
Population
Renal function
030209 endocrinology & metabolism
urologic and male genital diseases
Severity of Illness Index
03 medical and health sciences
0302 clinical medicine
Age Distribution
Diabetes mellitus
Internal medicine
medicine
Prevalence
Humans
Renal Insufficiency, Chronic
education
Aged
Ultrasonography
education.field_of_study
business.industry
Quebec
Odds ratio
Middle Aged
medicine.disease
Health Surveys
female genital diseases and pregnancy complications
Rheumatology
Calcaneus
Blood pressure
Cross-Sectional Studies
Female
030101 anatomy & morphology
business
Osteoporotic Fractures
Kidney disease
Glomerular Filtration Rate
Subjects
Details
- ISSN :
- 14332965
- Volume :
- 30
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
- Accession number :
- edsair.doi.dedup.....5105fbb87d2ffe31846239e11943de9f