Diabetes Elevates Risk of Fracture In Patients on Kidney Replacement Therapy

In the presence of diabetes, patients undergoing kidney replacement therapy (KRT) appear to be at an elevated risk of getting a fracture, according to a study.

Diabetes Elevates Risk of Fracture In Patients on Kidney Replacement Therapy
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The investigation included prevalent adult patients on hemodialysis (HD) or peritoneal dialysis (PD), as well as incident patients initiating KRT, using data from the Danish National Registries (HD, PD, kidney transplanted [KTX]). Adults who were not on KRT were also included in a comparison group.

All of the participants were then separated into two groups based on their diabetes status. They were tracked until the first fracture, emigration, death, or the conclusion of the study.

The entire study population included 4,074,085 people who were not on KRT and had diabetes, as well as 9,053 people who were on KRT and had diabetes. In individuals with end-stage kidney disease, diabetes was found in 18–30% of cases.

Diabetes led to an increased risk of fractures in end-stage kidney disease in Cox proportional hazards regression models, with the risk increase being largest among dialysis patients compared to those who were not on KRT and did not have diabetes.

The unadjusted hazard ratios for any first fracture linked with diabetes in the HD, PD, and KTX subgroups were 1.2 (95 percent confidence interval [CI], 1.0–1.3), 1.4 (95 percent CI, 1.1–1.7), and 1.7 (95 percent CI, 1.4–2.2).

Even after correcting for age, gender, past fractures, comorbidities, and medication, the results remained similar.

 

Source: Bone 2021;153:116158

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