Abstract: TH-PO569
Magnesium Exposure Increases Fracture Risks in Patients with CKD
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
- Yang, David Chih-Yu, Taipei Veterans General Hospital, Taipei, Taiwan
- Tarng, Der-Cherng, Taipei Veterans General Hospital, Taipei, Taiwan
Background
Bone fracture is a serious complication in CKD patients, which may lead to disability and reduced survival. In advanced CKD patients, blood magnesium (Mg) concentrations are usually above the normal range due to reduced kidney excretion of Mg. Excessive bone Mg may play a role in mineralization defects, leading to renal osteodystrophy. The present study aims to examine the relationship between Mg-containing antacid exposure and risk of incident hip fracture of CKD patients in a large, nationwide database.
Methods
Patients aged above 20 years old and diagnosed with CKD were identified from the National Health Insurance Research Database (NHIRD). From these eligible participants, study subjects in the case group were patients who were diagnosed with hip fracture, whereas the control group were selected randomly and matched to a case-patient by age, month and year of cohort entry, and Charlson comorbidity index score. The antacid usage, including Mg, aluminum, calcium, and other demographic characteristics, were analyzed.
Results
We enrolled 10,361 CKD patients with hip fracture, among which the mean age was 69.7 years old, and 54.7% was non-dialysis CKD. As compared to non-users, Mg-containing antacid users were significantly more likely to experience hip fracture (Adjusted odds ratio (OR) 1.15, 95% CI, 1.08 to 1.23; p < 0.001). Also, subgroup analysis showed that such risk exists in both non-dialysis CKD patients and long-term dialysis patients. In contrast, aluminum or calcium containing-antacid use did not reveal such association in our cohort. Next, we examined the influence of Mg-containing antacid dosage on hip fracture risk, the adjusted OR in the first quantile (Q1), Q2, Q3 and Q4, were 1.11 (95% CI, 1.02 to 1.20; p = 0.016), 1.23 (95% CI, 1.13 to 1.35; p < 0.001) , 1.33 (95% CI, 1.21 to 1.46; p < 0.001), and 1.20 (95% CI, 1.09 to 1.33; p = 0.001), respectively, showing that such risk exists regardless of the antacid dosage.
Conclusion
Our findings indicated that there is a strong link between Mg-containing antacid exposure and incident hip fracture risk in both non-dialysis CKD and dialysis patients, suggesting that Mg-containing antacid should be cautiously prescribed in the CKD population.
Funding
- Government Support - Non-U.S.