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Abstract: TH-PO722

A Sex-Specific Relationship Between Vascular Calcification and Incident Fracture in Patients with ESRD

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Lee, Yeonhee, The Catholic University of Korea, Incheon, Korea (the Republic of)
  • Nam, YunJung, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea (the Republic of)
  • Hwang, So yeon, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea (the Republic of)
  • Kim, Dongryul, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea (the Republic of)
  • Shin, Seok Joon, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea (the Republic of)
  • Yoon, Hye Eun, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea (the Republic of)
Background

Vascular calcification (VC) is a major component of mineral bone disorders in patients with end-stage renal disease (ESRD). The presence of VC is associated with low bone volume in ESRD patients. Bone metabolism is affected by various factors including sex hormones. However little is known about the sex-specific relationship between VC and incident fractures in ESRD patients. This study investigated whether there was a sex-specific relationship between the degree of VC and incident fracture in ESRD patients starting dialysis.

Methods

This was a retrospective cohort study including 593 incident dialysis patients from a single center. The aortic calcification index (ACI), an estimated of abdominal aortic calcification, was calculated by abdominal computed tomography as a measure of VC. Patients with ACI in the upper tertile range were considered to have high ACI (>25.75). The occurrence of fracture was assessed as study outcome. The association between high ACI and incident fracture was analyzed according to sex.

Results

During a median follow-up duration of 34.7 (0.03 – 147.5) months, 74 patients (12.4%) developed fracture. In the male group (n = 328), the fracture-free survival rate was not different between patients with high ACI and those with low ACI (P = 0.075). In the female group (n = 265), the fracture-free survival rate was significantly lower in patients with high ACI compared to those with low ACI (P = 0.002). In the male group, the high ACI was not associated with incident fracture (unadjusted hazard ratio, 1.96; 95% confidence interval, 0.92 – 4.15; P = 0.080). In the female group, the high ACI was independently associated with incident fracture after adjustments for confounding variables (adjusted hazard ratio, 2.53; 95% confidence interval, 1.29 – 4.98; P = 0.007).

Conclusion

In conclusion, VC is associated with incident fracture in female ESRD patients starting dialysis, while there was no association between VC and fracture in male ESRD patients. There may be a sex-specific relationship between VC and fracture in ESRD patients