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Abstract: SA-PO577

Changes in Modified Creatinine Index Following Bone Fractures in Patients Undergoing Maintenance Hemodialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Soeda, Keisuke, Tokai Daigaku Igakubu Jinnai Bunpu Taisha Naika, Isehara, Kanagawa, Japan
  • Komaba, Hirotaka, Tokai Daigaku Igakubu Jinnai Bunpu Taisha Naika, Isehara, Kanagawa, Japan
  • Nakagawa, Yosuke, Tokai Daigaku Igakubu Jinnai Bunpu Taisha Naika, Isehara, Kanagawa, Japan
  • Hida, Miho, Medical Corporation Kuratakai, Hiratsuka, Kanagawa, Japan
  • Kakuta, Takatoshi, Tokai Daigaku Igakubu Fuzoku Hachioji Byoin, Hachioji, Tokyo, Japan
  • Fukagawa, Masafumi, Tokai Daigaku Igakubu Jinnai Bunpu Taisha Naika, Isehara, Kanagawa, Japan

Group or Team Name

  • Division of Nephrology, Endocrinology and Metabolism.
Background

Previous research has shown associations between lower skeletal muscle mass and a subsequent increased risk of bone fractures in hemodialysis patients. However, limited data exist on whether fractures lead to a loss of muscle mass in this population.

Methods

We analyzed a historical cohort study of 2,292 patients undergoing maintenance hemodialysis in Japan. We compared longitudinal changes in modified creatinine index (mCI) as a surrogate marker of muscle mass in a subcohort of patients who experienced fractures during the 7-year study period and those who did not, matched by propensity score at 1:3. Follow-up started immediately prior to the occurrence of fracture in the fracture group and at study enrollment in the non-fracture group.

Results

During a median follow-up of 5.4 years (IQR, 2.5-7.0 years), 113 patients experienced clinical fractures, among which 84 patients had data on mCI over time. With the use of propensity-score matching, 66 patients who experienced a clinical fracture were matched with 198 patients who did not sustain a fracture. While the mCI remained virtually unchanged in the non-fracture group, there was a progressive decrease in mCI in the fracture group, with a 3.0% decrease from baseline at 1 year and an 8.0% decrease at 5 years. Similar findings were obtained for changes in nutritional indicators such as serum albumin and body mass index.

Conclusion

In patients undergoing maintenance hemodialysis, the occurrence of clinical fractures may lead to a subsequent reduction in muscle mass, as indicated by the modified creatinine index. Whether interventions to prevent muscle mass loss following a fracture improve clinical outcomes warrants further investigation.