Kidney Week

Abstract: TH-PO572

Five-Year Changes in Quadriceps Muscle Properties and Risk of Hip Fractures in Older Adults with Reduced and Normal Kidney Function: Nine Years of Follow-Up of the AGES-Reykjavik Study

Session Information

• Bone and Mineral Metabolism: Bone Disease
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 402 Bone and Mineral Metabolism: Clinical

Authors

• Marques, Elisa A., Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University Institute of Maia (ISMAI), Maia, Portugal

Elisa A. Marques,

• Viana, Joao L., University Institute of Maia, Maia, Portugal

Joao L. Viana,

• Leal, Diogo Vaz, University Institute of Maia, Maia, Portugal

Diogo Vaz Leal,

• Gudnason, Vilmundur, Icelandic Heart Association, Kopavogur, Iceland

Vilmundur Gudnason,

• Sigurdsson, Gunnar, Icelandic Heart Association Research Institute, Kópavogur, Iceland

Gunnar Sigurdsson,

• Lang, Thomas, University of California, San Francisco, San Francisco, California, United States

Thomas Lang,

• Sigurdsson, Sigurdur, The Icelandic Heart Association, Kópavogur, Iceland

Sigurdur Sigurdsson,

• Aspelund, Thor, Icelandic Heart Association, Kopavogur, Iceland

Thor Aspelund,

• Siggeirsdottir, Kristin, Icelandic Heart Association, Kopavogur, Iceland

Kristin Siggeirsdottir,

• Launer, Lenore J., National Institute on Aging, Bethesda, Maryland, United States

Lenore J. Launer,

• Eiriksdottir, Gudny, Icelandic Heart Association, Kopavogur, Iceland

Gudny Eiriksdottir,

• Harris, Tamara, National Institute on Aging, Bethesda, Maryland, United States

Tamara Harris,

Background

Chronic kidney disease (CKD) is associated with poor muscle and bone health, as well as an increased risk of fractures. However, the prediction of fractures from muscle-related parameters in older adults with impaired kidney function remains unknown. Therefore, this study aimed to determine the association of accelerated worsening of muscle properties over 5 years and incident hip fracture among older adults with reduced (estimated glomerular filtration rate < 60 ml/min/1.73 m²)and normal kidney function.

Methods

A total of 2311 older adults (33.1% CKD stage 3-4), aged 66-91 years at baseline from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study, who had completed data on baseline serum creatinine and potential covariates, and valid thigh quantitative computed tomography (QCT) scans and isometric testing at baseline and 5-years later were studied. Fracture predictors included: cross-sectional area (CSA, cm²), attenuation (Hounsfield unit), and maximum rate of torque development (RTD, N*m/s). Analyses employed Cox-proportional hazard regression models adjusted for potential covariates.

Results

During the median follow-up of 5.7 years, 202 (8%) hip fractures occurred. Having reduced kidney function was associated with an increased risk of hip fracture (HR= 1.6, 95% CI 1.2 – 2.1) compared to having normal kidney function. Adjusted for confounders, an accelerated decline (highest tertile of decline) in quadriceps muscle CSA was associated with higher hip fracture risk (HR =1.62, 95% CI= 1.03–2.54) only in reduced kidney function older adults, while an accelerated decline in muscle attenuation and RTD were not significant predictors of hip fracture in both normal and reduced kidney function subjects.

Conclusion

Our findings support that monitoring quadriceps muscle quantity changes and implementing exercise regimens may be two essential and clinically feasible steps to prevent functional decline and fracture risk, particularly in older adults with reduced kidney function.

Funding

• Other NIH Support