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Kidney Week

Abstract: FR-PO880

A Comparison between Hemodialysis and Peritoneal Dialysis on the Risk of Hip Fractures in Diabetics with Chronic Renal Disease

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Qureshi, Ammar, Marshall University, Huntington, West Virginia, United States
  • Aguilar, Fernando Rodrigo, Georgetown University Hospital , Washington, District of Columbia, United States
  • Benhamed, Nesreen, MUSOM , Barboursville, West Virginia, United States
Background

It is well established that bone fragility and fractures are common complications of patients on dialysis, notably if they are diabetics. It remains uncertain if the risk of fractures changes depending on the dialysis modality either hemodialysis (HD) or peritoneal dialysis (PD). We aim in this study to set the risk of bone fractures between those two modalities in patients with DM2.

Methods

Data was extracted from the 2005 to 2012 Nationwide Inpatient Sample (NIS). Using propensity score matching, ESRD-DM patients on PD were matched with patients on HD at a 1:1 ratio. Analyses were performed using SAS version 9.3 (SAS Institute, Cary, NC, USA).

Results

Among 586,238 patients with incident ESRD, 568,469(96.97%) and 17,769(3.03%) were initiated on HD and PD, respectively, during the hospitalization. After matching both groups, we find no difference in the rate of ulnar (0.1 vs 0.1; p=1) and hip fractures (0.3 vs 0.31; p=0.78) while spine (0.32 vs 0.21; p<0.0001) and humeral fractures (0.21 vs 0.15; p= 0.01) occur significantly more in the HD group.

Conclusion

Diabetic patients with ESRD on HD have higher risk for spine and humeral fractures. Further studies are needed to evaluate the different bone pathogenesis of both dialysis modalities to explain our findings.