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Kidney Week

Abstract: PO0399

Bone Fractures and Antihypertensive Drugs in CKD Patients: The Fukuoka Kidney Disease Registry (FKR) Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Shukuri, Tomoya, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Nakai, Kentaro, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Sato, Yoshiki, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Yamaoka, Nao, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Ishimatsu, Yukiko, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Inoue, Megumi, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Kohara, Chiaki, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Mitsuiki, Koji, Japanese Red Cross Fukuoka hospital, Fukuoka, Japan
  • Tanaka, Shigeru, Division of Internal Medicine, Fukuoka Dental College, Fukuoka, Japan
  • Nakano, Toshiaki, Department of Medicine and Clinical science, Graduate school of Medical Sciences,Kyushu University, Fukuoka, Japan
  • Tsuruya, Kazuhiko, Department of Nephrology, Nara Medical University, Nara, Japan
  • Kitazono, Takanari, Department of Medicine and Clinical science, Graduate school of Medical Sciences,Kyushu University, Fukuoka, Japan
Background

Patients with chronic kidney disease (CKD) are known to be at high risk for bone fractures. Bone fractures are serious complication that causes inactivity, hospitalization, and premature death. Some reports showed the association between bone fractures and antihypertensive drugs in elderly persons, but there are few reports in CKD patients. The aim of this study is to elucidate the relationship between bone fractures and antihypertensive drugs in CKD patients.

Methods

The Fukuoka Kidney disease Registry (FKR) Study is a prospective, multicenter cohort study of approximately 5000 patients with CKD. This is a cross-sectional study that investigated the relationship between antihypertensive drugs and bone fractures. The odds ratio (OR) of bone fractures in each risk factors was calculated by performing a logistic regression model analysis with adjustment factors, such as age, sex, body mass index(BMI), smoking history, presence of diabetes mellitus, eGFR levels, serum levels of albumin, sodium, calcium, phosphate, parathyroid hormone(intact assay).

Results

A total of 4474 patients were included in this study (age 63.9 years, men 56.0%, BMI 23.4 kg/m2, diabetes mellitus 27.5%, and smoking history 52.0%).The average eGFR was 44.0ml/min/1.73 m2, with 60.0 ml/min/1.73 m2 or more at 24.2%, 30.0-60.0 ml/min/1.73 m2 at 39.5%, and less than 30.0 ml/min/1.73 m2 at 36.3%. Bone fractures were found in 282 patients(6.3%). Loop diuretics were independently associated with bone fractures (OR: 1.75, 95% confidence interval [CI]: 1.24-2.49), and angiotensin II receptor blockers (ARB) had significantly fewer bone fractures (OR: 0.64, CI: 0.49-0.85). Angiotensin-converting enzyme inhibitors, calcium channel blockers, alpha blockers, beta blockers, and thiazide diuretics were not showed significant association with bone fractures.

Conclusion

It is suggested that loop diuretics may be associated with higher bone fractures risk and ARB may be associated with lower bone fractures risk in CKD patients. The results are being verified in this prospective cohort by future.