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Kidney Week

Abstract: PO0575

Prescription Patterns of Osteoporosis Medications in Patients with CKD Stages 4-5: A Retrospective Cohort Study

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Portales Castillo, Ignacio A., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Aksu, Cagri, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Yu, Elaine W., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Nigwekar, Sagar U., Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Patients with CKD stages 4-5 are at greater than 2-fold risk of fractures than age-matched controls without CKD, but there is very limited data about the use of antiresorptive or bone anabolic medications in this population. Our goal was to compare the proportion of patients with CKD stages 4-5 vs CKD stages 2-3 who were prescribed these medications at our institution.

Methods

Using the Research Patient Data Registry (RPDR), a centralized clinical data registry at Mass General Brigham, we screened for all adults ≥55 years old with a diagnosis of CKD by ICD10 codes and a DXA scan available between years 2000-2019. We then identified CKD stages by eGFR and matched 100 patients with CKD stages 4-5 to 100 patients with CKD stages 2-3.

Results

Demographic characteristics were similar between the groups (Table 1). Despite having lower femoral bone density, patients with CKD stages 4-5 had lower rates of osteoporosis treatment than patients with CKD 2-3 (50% vs 72%, P=0.001). In all CKD groups, the most common class of medication used was bisphosphonates (Figure 1). Of note, 47% of patients using antiresorptive medications with stages 4-5 CKD had PTH levels lower than 100 pg/ml.

Conclusion

We found lower rates of osteoporosis treatment in patietns with CKD stages 4-5. Despite PTH levels consistent with normal or adynamic bone disease, most CKD patients are treated with antiresoprtive medicines. Our study calls attention to knowledge gaps in osteoporosis and CKD.