Long-term excess mortality after hip fracture in hemodialysis patients: a nationwide cohort study in Japan

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

doi:10.1007/s00774-020-01110-4

Cited by 10 publications

(15 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As for the 90-day follow-up, the mortality increases with lower eGFR values. Some authors have pointed out excess mortality after hip fracture in haemodialysis patients 7 , 23 , 24 , emphasizing that hip fracture is a critical event for the survival of this group of patients. A higher mortality rate in patients with advanced CKD has been shown in femoral neck fracture patients 14 , and in all types of hip fractures in the longer term 19 .…”

Section: Discussionmentioning

confidence: 99%

Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment

Da Casa,

Vidal-Terrancle,

Hierro-Estévez

et al. 2023

An Sist Sanit Navar

View full text Add to dashboard Cite

Background: We assessed the relationship of estimated glomerular filtration rate values at hospital admission on the outcome of surgically treated older adults who had suffered a hip fracture. Methods: Prospective study that included patients > 65 years of age, surgically treated for primary hip fracture, with no pathologic or high-energy trauma aetiology admitted to a tertiary teaching hospital between 2018 and 2019. We stratified patients based on their estimated glomerular filtration rate at admission and examined its association to demographic and clinical variables, including 90-day post-discharge mortality. Results: The study included 942 hip fracture patients. Lowered estimated glomerular filtration rate was significantly associated to a worsening of the functional status, higher incidence of medical postoperative complications, higher postoperative renal dysfunction, and greater number of blood transfusions. Mortality displayed a staircase pattern, increasing with decreasing estimated glomerular filtration rate. Patients with estimated glomerular filtration rate <60 had significantly higher mortality at 90 days after discharge. In-hospital mortality rate was 10.7% in hip fracture patients with chronic kidney disease who experienced a significant variation in the estimated glomerular filtration rate (>5 mL/min/1.73m 2 ) on admission in comparison to baseline values. Conclusion: Older adult patients treated for hip fracture with lower glomerular filtration rate values have poorer functional status and worse prognosis. A significant clinical variation of estimated glomerular filtration rate upon hospital admission for hip fracture may be associated with increased in-hospital mortality of chronic kidney disease patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment

Da Casa,

Vidal-Terrancle,

Hierro-Estévez

et al. 2023

An Sist Sanit Navar

View full text Add to dashboard Cite

show abstract

“…A cohort study of 679,114 participants showed that the risk of fracture during the 3-year observation period was high in both sexes when eGFR was ≤15 mL/min and participants were aged ≥65 years [ 71 ]. A Japanese cohort study of 162,360 participants examined 5-year all-cause mortality and cause-specific mortality and showed that crude mortality rates doubled in participants with hip fracture; this higher mortality persisted during the 5-year period [ 72 ].…”

Section: Outcomes and Complications In Hyperphosphatemiamentioning

confidence: 99%

The Importance of Phosphate Control in Chronic Kidney Disease

Tsuchiya

Akihisa

2021

Nutrients

View full text Add to dashboard Cite

A series of problems including osteopathy, abnormal serum data, and vascular calcification associated with chronic kidney disease (CKD) are now collectively called CKD-mineral bone disease (CKD-MBD). The pathophysiology of CKD-MBD is becoming clear with the emerging of αKlotho, originally identified as a progeria-causing protein, and bone-derived phosphaturic fibroblast growth factor 23 (FGF23) as associated factors. Meanwhile, compared with calcium and parathyroid hormone, which have long been linked with CKD-MBD, phosphate is now attracting more attention because of its association with complications and outcomes. Incidentally, as the pivotal roles of FGF23 and αKlotho in phosphate metabolism have been unveiled, how phosphate metabolism and hyperphosphatemia are involved in CKD-MBD and how they can be clinically treated have become of great interest. Thus, the aim of this review is reconsider CKD-MBD from the viewpoint of phosphorus, its involvement in the pathophysiology, causing complications, therapeutic approach based on the clinical evidence, and clarifying the importance of phosphorus management.

show abstract

“…Preventing the onset of fractures and taking appropriate countermeasures are important. 4 Many osteoporosis medications are contraindicated or require careful administration in patients undergoing dialysis. 5 Consequently, these patients may not receive su cient treatment for osteoporosis.…”

Section: Introductionmentioning

confidence: 99%

Effect of denosumab on the incidence of fractures and mortality in patients undergoing hemodialysis: A retrospective cohort study

Kobayashi,

Yaginuma,

Kato

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Patients undergoing hemodialysis are at an elevated risk of fractures; however, substantial evidence on osteoporosis treatment in this population is lacking. We explored the efficacy of denosumab, an anti-IgG2 antibody, in reducing fracture incidence and all-cause mortality in patients undergoing hemodialysis. Methods: This retrospective cohort study—conducted from December 2013 to December 2022—evaluated the effects of denosumab on fracture incidence and mortality. Kaplan–Meier curves and log-rank tests were used to assess survival and fracture/mortality risks, respectively. A Cox proportional hazards model was used to analyze fractures and all-cause mortality. Results: Among 263 patients undergoing hemodialysis, 52 (19.8%) received denosumab. The median age was 71.7±12.1 years, with 93 (35.4%) females, and the median dialysis duration was 48 months (interquartile range, 4–114). During the study, 52 (22.8%) non-denosumab-treated patients had fractures compared to eight (3.0%) in the denosumab group. No significant differences were observed in the unadjusted model (HR, 0.51; 95% CI, 0.24–1.08). Adjusting for competing mortality and clinical factors, the HR remained at 0.51 (95% CI, 0.22–1.20). Regarding all-cause mortality, no significant differences were observed in the unadjusted model (HR, 0.68 [95% CI, 0.43–1.07]); however, a significant reduction in mortality was observed in the adjusted model (HR, 0.46 [95% CI, 0.26–0.81]). Notably, the denosumab group showed a significant decrease in mortality, particularly in cardiovascular disease-related cases (HR, 0.32 [95% CI, 0.14–0.75]). Conclusions: Denosumab may significantly reduce all-cause mortality in patients undergoing hemodialysis, particularly in those with cardiovascular complications. This finding offers a promising direction for osteoporosis treatment in patients undergoing hemodialysis.

show abstract

Long-term excess mortality after hip fracture in hemodialysis patients: a nationwide cohort study in Japan

Cited by 10 publications

References 31 publications

Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment

Lower estimated glomerular filtration rate at admission is associated with a worse outcome in older patients with hip fracture who undergo surgical treatment

The Importance of Phosphate Control in Chronic Kidney Disease

Effect of denosumab on the incidence of fractures and mortality in patients undergoing hemodialysis: A retrospective cohort study

Contact Info

Product

Resources

About