Predictors of bone fractures in a single-centre cohort of hemodialysis patients: a 2-year follow-up study

Brunerová, Ludmila; Lažanská, Renata; Kasalický, Petr; Verešová, Jana; Potočková, Jana; Fialová, Alena; Rychlík, Ivan

doi:10.1007/s11255-018-1958-y

Cited by 12 publications

(6 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 1426 men and women (mean age 67 y), reduced kidney function was associated with significantly lower TBS and a higher probability of fracture (18% vs. 6%, p = 0.01) and low TBS predicted greater incidence of fragility fractures over 4.7 years, independent of BMD and CRFs [ 110 ]. Lower TBS also corresponds with increasing disease severity [ 111 , 112 ]. In hemodialysis patients (mean age 74 y), TBS and not BMD, was a significant, independent predictor of fracture [ 115 ].…”

Section: Resultsmentioning

confidence: 99%

Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

et al. 2023

View full text Add to dashboard Cite

Purpose Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice. Supplementary Information ...

show abstract

Section: Resultsmentioning

confidence: 99%

Update on the clinical use of trabecular bone score (TBS) in the management of osteoporosis: results of an expert group meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), and the International Osteoporosis Foundation (IOF) under the auspices of WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging

et al. 2023

View full text Add to dashboard Cite

show abstract

“…The majority of patients with fracture had shorter hemodialysis duration (<4 years vs. ≥4 years: 40% vs. 17.8%; P = 0.027) and a history of steroid use (non-user vs. user: 21.7% vs. 63.6%; P = 0.004). Although, the medians of the FRAX® results for MOF and hip fracture were higher in the group with fracture, the difference between two groups did not reach statistical significance (fracture vs. no fracture: 9% (1.2–22) vs. 4.3% [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]; P = 0.066 for MOF and 3.8% (0.1–17) vs. 1.9% (0.1–12); P = 0.102 for hip fracture ( Table 1 ). Comparisons of current laboratory values revealed no differences in serum albumin-corrected calcium, phosphate, ALP, PTH, bicarbonate, and hemoglobin concentrations between the two groups.…”

Section: Resultsmentioning

confidence: 95%

“…It is well established that systemic disorder of mineral and bone metabolism due to CKD, also known as CKD-mineral and bone disorder (CKD-MBD), affects bone strength and quality [ 10 , 11 ]. In previous studies in patients with CKD, advanced age; low bone mineral density (BMD); low body mass index (BMI); narcotic and psychoactive medication use; low 25-hydroxyvitamin D [25(OH)D]; abnormal parathyroid hormone (PTH), phosphorus, calcium, and total alkaline phosphatase (ALP) concentrations; and high Fracture Risk Assessment Tool (FRAX®) for major osteoporotic fracture were associated with low-trauma fracture [ 12 , 13 , 14 , 15 , 16 ]. Long-term dialysis vintage was correlated with hip and vertebral fracture in studies with small sample sizes [ 7 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and predictors of asymptomatic vertebral fracture in patients with end-stage renal disease

Jirasirirak

Disthabanchong

Ongphiphadhanakul

et al. 2022

Heliyon

View full text Add to dashboard Cite

“…Although the author recognizes the importance of other markers such as FRAX and low vitamin D level, he defined that only low bone mineral density can be considered as a predictive factor for low impact fractures. 30 Another study conducted in a population of diabetics showed that, although the bone mineral density in prediabetic and diabetic patients is higher than that found in normoglycemics, the bone quality of bone microarchitecture (TBS) showed no difference. 31 In a cohort also performed in diabetics, the importance of TBS evaluation in this population was reinforced, especially in the evaluation of the proximal femur.…”

Section: Discussionmentioning

confidence: 98%

Relationship Between TBS Score, Bone Density and Fractures in Older Men: Integrative Review

2022

View full text Add to dashboard Cite

Population ageing is an inexorable truth. This is the reason for an increase in the number of studies analyzing common pathologies, such as osteoporosis, in older people. Osteoporosis is a disease resulting from bone fragility, thus increasing the risk of fracture. Although the occurrence is predominant in women, studies analyzing the male population have raised interest among the scientific community. Nevertheless, there is no consensus regarding the best way to estimate the risk of fracture. Bone density testing and TBS (trabecular bone score) assessments are alternatives available for diagnosing. To assess the relationship between bone mineral density, the changes in TBS and fractures in older men. We conducted an integrative review of the literature in the LILACS, Scopus and PubMed databases, searching for studies in the last five years. We found 97 studies, and five of these matched our guiding question. We found five articles that matched our selecting criteria. All five presented the importance of using TBS for a better accuracy in improving the estimate of risk of fracture in older men. The association of TBS with bone density is important to best estimate the risk of fracture in elder men. Level of Evidence II, Diagnostic Studies.

show abstract

Predictors of bone fractures in a single-centre cohort of hemodialysis patients: a 2-year follow-up study

Cited by 12 publications

References 54 publications

Prevalence and predictors of asymptomatic vertebral fracture in patients with end-stage renal disease

Relationship Between TBS Score, Bone Density and Fractures in Older Men: Integrative Review

Contact Info

Product

Resources

About