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Kidney Week

Abstract: TH-PO765

Rates of Prevalent Fracture Differ by Race and Ethnicity in Children with CKD

Session Information

  • Pediatric CKD
    November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1700 Pediatric Nephrology


  • Laster, Marciana, Mattel Children's Hospital, Los Angeles, California, United States
  • Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Okuda, Yusuke, University of California, Irvine, Irvine, California, United States
  • Kumar, Juhi, Weill Cornell Medical College, New York, New York, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine, School of Medicine, Orange, California, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Salusky, Isidro B., Mattel Children's Hospital, Los Angeles, California, United States

Studies of healthy children demonstrate higher rates of fracture in Caucasian as compared to minority children. Although studies in adults with CKD have demonstrated greater risk of fracture in Caucasian adults as well, there is limited data on fracture rate differentials by racial-ethnic group in the pediatric CKD population.


In a sample of 742 children between the ages of 1.5 years and 18 years, with CKD stages 1-4 from the CKD in children (CKiD) cohort, we determined the relationship between racial-ethnic group and the reported history of fracture upon entry to the study. Using logistic regression, we sequentially controlled models for the potential confounders in Table 1 which were chosen based upon prior literature and bivariate p-values <0.1. Multiple imputation was used for missing values in the final model.


The cohort characteristics and laboratory values are displayed in Table 1. Vitamin D levels were lowest in African-American children. 142 subjects reported ever having experienced a broken bone. In the fully adjusted and multiply imputed model, African-American and Hispanic children had 74% (OR [CI] 0.26 [0.14, 0.49] p=0.001)and 66% (OR [CI] 0.34 [0.17, 0.65], P<0.0001) lower odds of any fracture than Caucasian children at study entry, respectively (Figure 1).


Despite lower vitamin D levels, African-American children with CKD reported lower fracture frequency than Caucasian children. These findings in children with CKD are similar to those in healthy children. Additional studies to understand the pathophysiologic mechanisms behind these differentials are warranted.


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