Abstract: SA-PO890

Risk Factors of Fractures in Patients with Stage 3 CKD: Analysis of CARTaGENE

Session Information

  • Mineral Disease: CKD-Bone
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Mineral Disease

  • 1203 Mineral Disease: CKD-Bone

Authors

  • Desbiens, Louis-Charles, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
  • Goupil, Remi, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Madore, Francois, Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada
  • Sidibé, Aboubacar, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
  • Mac-Way, Fabrice, Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
Background

The association between end-stage renal disease and increased fracture risk is well described. However, whether mild chronic kidney disease (CKD) is also associated with higher fracture risk is poorly known. We aimed to determine if mild CKD increases fracture risk vs general population. Secondary objectives were to evaluate whether bone mineral density (BMD) is associated with fracture and to compare the risk factors of fractures in mild CKD vs general population.

Methods

Cross-sectional, retrospective study of the CARTaGENE cohort, a large health population-based survey of 40 to 69 years old individuals from province of Quebec (Canada). Patients with CKD stage 3 (eGFR between 30 and 60 ml/min/1,73m2) were compared to controls (eGFR > 60 ml/min/1,73m2). Self-reported fractures were classified as osteoporotic (femur, hip, rib, vertebra, wrist, pelvis, sacrum) or total fractures. Fracture risk was adjusted for baseline demographic, clinical, pharmacological and biochemistry parameters using multivariate logistic regression. Stepwise multivariate regressions stratified for CKD were performed to evaluate risk factors of fractures.

Results

17,614 patients without anti-resorptive therapy had available data on fractures and BMD (656 CKD and 16,958 controls). CKD patients (mean eGFR 53±6 ml/min/1,73m2) were older, had more diabetes, cardiovascular disease, hypertension, smokers and a lower BMD t-score. Total but not osteoporotic fracture risk was higher in CKD patients, but remained similar when stratified by age group and after adjustments for covariables. In multivariate stepwise models, BMD t-score and use of benzodiazepines were associated with total fracture in both groups. Total cholesterol levels and mean blood pressure were associated with fracture in CKD while age, smoking and body mass index were associated with fracture in control group.

Conclusion

Stage 3 CKD patients have a similar fracture risk but different risk factors for fracture vs general population. Our results suggest that bone pathology in CKD is different from the general population even at early stages of CKD.

Funding

  • Government Support - Non-U.S.