Hip Fracture Trends in Japanese Dialysis Patients, 2008-2013

Wakasugi, Minako; Kazama, Junichiro James; Wada, Atsushi; Hamano, Takayuki; Masakane, Ikuto; Narita, Ichiei

doi:10.1053/j.ajkd.2017.07.017

Cited by 24 publications

(20 citation statements)

References 24 publications

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“…End‐stage renal disease patients also are at an extremely high risk of bone fractures because of the high incidence of uremic osteoporosis and MBD . Compared with normal population, uremic patients are more prone to having abnormal bone metabolism, a disarranged bone microarchitecture, lower bone mass and musculoskeletal fragility .…”

Section: Uremic Osteoporosis‐related Bone Quality Lossmentioning

confidence: 99%

“…End-stage renal disease patients also are at an extremely high risk of bone fractures because of the high incidence of uremic osteoporosis and MBD. 76,77 Compared with normal population, uremic patients are more prone to having abnormal bone metabolism, a disarranged bone microarchitecture, lower bone mass and musculoskeletal fragility. 78,79 The concept of 'uremic osteoporosis' was recently introduced by Fukagawa et al 5,80 to explain the role of uremic toxins in influencing bone quality in CKD patients.…”

Section: Uremic Osteoporosis-related Bone Quality Lossmentioning

confidence: 99%

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Mineral bone disorders in chronic kidney disease

Hou

2018

Nephrology

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As the GFR loss aggravates, the disturbed mineral metabolism worsens the bone microstructure and remodelling ‐ scenario, which is known as CKD‐mineral bone disease (MBD). CKD‐MBD is characterized by : (i) abnormal metabolism of calcium, phosphorus, parathyroid hormone (PTH), or vitamin D; (ii) abnormalities in bone turnover, mineralization, volume linear growth or strength; (iii) soft‐tissue calcifications, either vascular or extra‐osseous. Uremic vascular calcification and osteoporosis are the most common complications related to CKD‐MBD. Disregulated bone turnover by uremic toxin or secondary hyperparathyroidism disturbed bone mineralization and makes it difficult for calcium and inorganic phosphate to enter into bone, resulting in increased serum calcium and inorganic phosphate. Vascular calcification worsens by hyperphosphatemia and systemic inflammation. Since vitamin D deficiency plays an important role in renal osteodystrophy, supplement of nutritional vitamin D is important in treating uremic osteoporosis and vascular calcification at the same time. Its pleotropic effect improves the bone remodeling initiated by osteoblast and alleviates the risk factors for vascular calcification with less hypercalcemia than vitamin D receptor analogs. Therefore, nutritional vitamin D should be considered in managing CKDMBD.

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Section: Uremic Osteoporosis‐related Bone Quality Lossmentioning

confidence: 99%

Section: Uremic Osteoporosis-related Bone Quality Lossmentioning

confidence: 99%

Mineral bone disorders in chronic kidney disease

Hou

2018

Nephrology

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“…In the contrary, the incidence of hip fractures among haemodialysis patients is increasing [22,23]. However, in Japan, compared to the general population, in Japanese dialysis patients, the incidence of hip fractures decreased among women but did not change among men between 2008 and 2013 [24]. Although the incidence of hip fractures appears to have decreased slightly, it remains a challenging problem in dialysis patients for both orthopaedic surgeons and nephrologists [25].…”

Section: Discussionmentioning

confidence: 99%

Simultaneous bilateral femoral neck fractures in a dialysis-dependent patient: case report and literature review

Zhu

Han

et al. 2020

BMC Musculoskelet Disord

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Background: Simultaneous bilateral femoral neck fractures are extremely rare without obvious injury. Herein, we report the case of a patient on dialysis presenting with bilateral femoral neck fractures, which is a condition with high complication and mortality rates according to a review of the pertinent literature. Case presentation: We report the case a 47-year-old female with a history of 8 years of haemodialysis due to polycystic kidney disease who presented with bilateral hip pain during walking. The clinical history and results of physical and radiographic examinations of this patient are shown. Single-stage bilateral hemiarthroplasty was performed after a multidisciplinary team consultation. Three days after the operation, she could ambulate with a walker. The woman gradually regained her previous ability to walk over 6 months after surgery. Conclusions: A multidisciplinary team consultation for perioperative management is necessary and effective in patients on dialysis. Early diagnosis with prompt surgical treatment could lead to favourable recovery.

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“…Second, we repeated analyses among only thrice-a-week dialysis patients, because the effects of time and frequency on hip fracture incidence may vary even if HDP values remain the same. Third, subgroup analysis stratified by sex was performed, because sex is a significant predictor of the incidence of hip fracture (16,18,(20)(21)(22)(23)(24)(25). Finally, we additionally explored the continuous, potentially nonlinear relationship between baseline HDP and hip fracture events by using fully adjusted, restricted cubic spline models.…”

Section: Statistical Analysesmentioning

confidence: 99%

Hemodialysis Product and Hip Fracture in Hemodialysis Patients: A Nationwide Cohort Study in Japan

et al. 2019

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Some have raised concerns that longer and more frequent hemodialysis (HD) would be associated with bone fractures due to excess phosphate removal. We examined the effects of hemodialysis product (HDP) on hip fracture incidence among Japanese HD patients using registry data of the Japanese Society for Dialysis Therapy. During a 1‐year study period, 1411 hip fractures occurred among 135 984 patients. After adjusting for demographic and clinical factors, patients with a high HDP did not show a significant risk of hip fracture. Interestingly, patients with polycystic kidney disease had a lower risk of hip fracture. Our findings did not support the hypothesis that patients undergoing longer and more frequent HD would face a higher risk of hip fracture than those undergoing shorter and less frequent HD. Polycystic kidney disease was identified as a new significant factor for hip fracture; relative to glomerulonephritis, this condition was associated with a lower risk of hip fracture.

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Hip Fracture Trends in Japanese Dialysis Patients, 2008-2013

Cited by 24 publications

References 24 publications

Mineral bone disorders in chronic kidney disease

Mineral bone disorders in chronic kidney disease

Simultaneous bilateral femoral neck fractures in a dialysis-dependent patient: case report and literature review

Hemodialysis Product and Hip Fracture in Hemodialysis Patients: A Nationwide Cohort Study in Japan

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