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.
 |
| Photo: Hip Joint Fracture | InStyleHealth |
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