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Kidney Week

Abstract: FR-PO698

Comparison of the Risk of Fracture in Peritoneal Dialysis Patients with Sarcopenia Using the FRAX

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Lee, Heeryong, Maryknoll Medical center, Busan, Korea (the Republic of)
  • Ahn, Jeongmyung, Maryknoll Medical center, Busan, Korea (the Republic of)
  • Lee, Dong Ryeol, Maryknoll Medical center, Busan, Korea (the Republic of)
Background

For chronic patients with chronic diseases such as peritoneal dialysis, the rate of sarcopenia is high. This sarcopenia increases the risk of dying by causing heart failure, fractures, infection, frailty, and resistance to insulin. This study was initiated because of the lack of evidence of a risk of fractures in patients with peritoneal dialysis.

Methods

: We studied 146 patients on peritoneal dialysis. For the diagnosis of sarcopenia, we measured muscle mass (measured using a bioimpedance analysis), muscle strength (measured using a handgrip strength), and physical performance (measured using a gait speed). Sarcopenia was diagnosed on the basis of the European Working Group on Sarcopenia in Older People (EWGSOP). The risk of fracture was measured using the fracture risk assessment tool (FRAX) after measuring the femoral neck bone mineral density. The FRAX is computerized algorithm that determines fracture probability in individuals by integrating important individual clinical risk factors for fracture and mortality.

Results

The mean age was 57.7 ± 11.8; There are 63 men and 83 women. There were 101 patients with continuous ambulatory peritoneal dialysis and 45 patients with automated peritoneal dialysis. A total of 45 patients were sarcopenia (30.8 %), of which 21 were men and 24 were women. There was no difference between the two groups of dialysis duration (1713.4 ± 1621.6 days vs 1804.3 ± 1917.4 days, p=0.761). Differences in values of the 10-year probability of fractures were seen depending on the presence of sarcopenia. The risk of 10-year of major osteoporotic fractures was low in a group that did not have sarcopenia (4.3 ± 3.0 % vs. 6.9 ± 5.9, p = 0.021). And the risk of 10-year of hip fractures was also lower in the group without sarcopenia (1.3 ± 2.0 vs 2.3 ± 1.5, p=0.022).

Conclusion

In peritoneal dialysis patients, the risk of fractures increases if they have sarcopenia. In peritoneal dialysis patients, it is desirable to reduce the risk of fractures by preventing sarcopenia.