Trabecular bone score in patients with chronic kidney disease
- PDF / 288,613 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 47 Downloads / 214 Views
ORIGINAL ARTICLE
Trabecular bone score in patients with chronic kidney disease C. Rampersad 1
&
R. H. Whitlock 1,2 & W. D. Leslie 1 & C. Rigatto 1,2 & P. Komenda 1,2 & C. Bohm 1,2 & D. Hans 3 & N. Tangri 1,2
Received: 14 November 2019 / Accepted: 7 May 2020 # International Osteoporosis Foundation and National Osteoporosis Foundation 2020
Abstract Summary Patients with chronic kidney disease have high risk of osteoporotic fractures. Lower trabecular bone score (TBS) was associated with poorer kidney function and higher fracture risk when kidney function was normal. Addition of TBS to The Fracture Risk Assessment Tool with bone mineral density did not improve fracture risk prediction. Introduction We sought to determine whether trabecular bone score (TBS) either independently or adjusted for The Fracture Risk Assessment Tool (FRAX) could predict risk of major osteoporotic fractures (MOFs) in a large population-based sample of patients with all stages of chronic kidney disease (CKD). Methods We used population-based administrative databases to identify patients above age 20 years who had dual-energy X-ray absorptiometry (DXA) scan and serum creatinine measured within 1 year, during the years 2005 to 2010. Patients were excluded if they were on dialysis or had a functioning renal transplant. We stratified patients by estimated glomerular filtration rate (eGFR). We collected femoral neck bone mineral density (BMD), lumbar spine TBS, incident major osteoporotic fractures (MOF) and hip fractures, and other clinical characteristics. Results Among 8289 patients, there were 6224 (75.1%) with eGFR ≥ 60 mL/min/1.73 m2, 1624 (19.6%) with eGFR 30–60 mL/ min/1.73 m2, and 441 (5.3%) with eGFR < 30 mL/min/1.73 m2. There were 593 patients (7.2%) with MOFs and 163 (2.0%) with hip fractures. Lower TBS score was associated with increased risk of MOF and hip fractures across all eGFR strata in unadjusted Cox proportional hazards models but after adjusting for FRAX with BMD, lower TBS was only statistically significant for MOF prediction for eGFR ≥ 60 mL/min/1.73 m2. Conclusion Lower TBS scores were associated with lower eGFR and increased fracture risk in patients with eGFR ≥ 60 mL/min/ 1.73 m2. However, the addition of TBS to the FRAX score with BMD did not significantly improve fracture risk prediction in patients with CKD. Keywords Bone mineral density . Chronic kidney disease . Fracture . FRAX . Trabecular bone score
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00198-020-05458-1) contains supplementary material, which is available to authorized users. * C. Rampersad [email protected] 1
Rady Faculty of Health Sciences, University of Manitoba, GF324– 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
2
Seven Oaks General Hospital, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
3
Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Chronic kidney disease (CK
Data Loading...
