Fracture Status in Middle-aged Individuals with Early CKD: Cross-sectional Analysis of the CARTaGENE Survey

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2019 Feb 24

PMID 30796539

Citations 1

Authors

L-C Desbiens

R Goupil

A Sidibe

F Madore

F Mac-Way

Affiliations

Soon will be listed here.

Abstract

Introduction: The association between advanced CKD and increased fracture risk is well described. However, whether early CKD is associated with increased fractures, especially in middle-aged adults, is unclear. We aimed to assess if early CKD is associated with increased fracture status and whether early CKD status modifies the association between calcaneal quantitative ultrasound parameters, clinical, pharmacological parameters, and fractures.

Methods: Cross-sectional analysis of CARTaGENE, a population-based survey of 40- to 69-year-old individuals. Individuals with CKD (stage 2, estimated glomerular filtration rate [eGFR] 60-89 ml/min/1.73 m; stage 3, eGFR 30-59) were compared to non-CKD individuals (eGFR > 90). Fracture status (excluding face, toe, hand, and patella) was identified through a questionnaire at baseline. Calcaneal quantitative ultrasound (QUS) was measured in each participant.

Results: A total of 17,608 individuals (656 CKD stage 3; 8227 stage 2; 8725 non-CKD) were included. CKD stage 2 and 3 individuals (mean eGFR 78 and 53 ml/min/1.73 m) were older and had more diabetes, cardiovascular disease, and hypertension. Fracture status prevalence was 14.9% in CKD stage 3, 10.8% in CKD stage 2, and 9.0% in non-CKD individuals. Fracture status prevalence was similar between CKD and non-CKD individuals when stratified by age or after adjustment for demographic and clinical parameters. QUS stiffness index was associated with fracture status in both CKD stage 3 (standardized odds ratio [sOR] = 1.525 [1.200 to 1.939] per 1 SD decrease), stage 2 (sOR = 1.415 [1.310 to 1.530]), and non-CKD individuals (sOR = 1.477 [1.361 to 1.602]). The associations between blood pressure, antihypertensive, and fracture status followed a U-shape throughout the progression of CKD.

Conclusions: CKD stage 3 was not associated with an increase in fracture status. QUS parameters were similarly associated with fracture status in patients with and without CKD.

Citing Articles

Association of aberrant mineral metabolic markers with fracture risk in chronic kidney disease: a comprehensive meta-analysis.

Liu Y, Zhang Z, Fu C, Ye Z, Jin H, Yang X BMC Nephrol. 2025; 26(1):68.

PMID: 39934684 PMC: 11818153. DOI: 10.1186/s12882-025-03992-w.

Incident vertebral fracture and longitudinal BMD change in Chinese postmenopausal women with early CKD: Peking Vertebral Fracture Study.

Jiajue R, Liang H, Jiang Y, Cui L, Pang Q, Chi Y Arch Osteoporos. 2023; 18(1):116.

PMID: 37697181 DOI: 10.1007/s11657-023-01324-9.

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