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Chronic kidney disease and hip-fracture mortality in older people in the UK

Chronic kidney disease and hip-fracture mortality in older people in the UK
Chronic kidney disease and hip-fracture mortality in older people in the UK
BACKGROUND: Dialysis patients have increased hip fracture rates when compared to the general population of the same age and sex. There have been few studies of the association of earlier stages of chronic kidney disease (CKD) with hip fractures amongst older people in the general population. The aim of this study was to examine whether CKD at older ages is associated with hip-fracture-related mortality. METHODS: In a trial of health and social assessment of people aged 75 and over in the UK with baseline assessment between 1995 and 1998, there were 13 177 (87%) participants in 53 general practices who had a serum creatinine measured at baseline. Estimated glomerular filtration rate (eGFR) was derived from the modification of diet in renal disease formula (MDRD). Mortality follow-up using linkage to national mortality data was until the end of November 2005. We used propensity scores to adjust for potential confounders in Cox regression models. RESULTS: There were 84 hip-fracture-related deaths over a median follow-up of 7.25 years (IQR 3.79-8.77). Compared to eGFR 60 ml/min/1.73 m(2) and above, the age- and sex-adjusted hazard ratio (HR) for hip-fracture-related death was 1.06 (95% confidence interval: 0.71, 1.58) for eGFR 45-59 and 1.98 (1.12, 3.50) for eGFR < 45. In adjusted models, the HR for eGFR < 45 ml/min/1.73 m(2) compared to above was 1.81 (1.11, 2.96). CONCLUSIONS: Amongst older people, an eGFR of <45 ml/ min/1.73 m(2) is associated with an almost 2-fold increase in hip-fracture-related mortality
aged, serum, people, population, kidney, follow up, mortality data, creatinine, disease, hip fractures, mortality, general-practice, model, hip, methods, health, deaths, sex, rates, patients, london, trial, fractures, glomerular filtration rate, death, follow-up, hygiene, general practice, diet, chronic, epidemiology
1539-1544
Nitsch, Dorothea
154b7a47-f777-4daa-b984-37447a6ad886
Mylne, Adrian
663a11eb-06ad-4ace-9c37-76c6698bca62
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smeeth, Liam
bf63d51e-40ce-4918-b5bc-0b365f49b677
Hubbard, Richard
e841dd58-2d17-4dbb-b8bb-16ec81a050f8
Fletcher, Astrid
65398be8-d617-4668-9cf6-9f8cb0bd6d74
Nitsch, Dorothea
154b7a47-f777-4daa-b984-37447a6ad886
Mylne, Adrian
663a11eb-06ad-4ace-9c37-76c6698bca62
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smeeth, Liam
bf63d51e-40ce-4918-b5bc-0b365f49b677
Hubbard, Richard
e841dd58-2d17-4dbb-b8bb-16ec81a050f8
Fletcher, Astrid
65398be8-d617-4668-9cf6-9f8cb0bd6d74

Nitsch, Dorothea, Mylne, Adrian, Roderick, Paul J., Smeeth, Liam, Hubbard, Richard and Fletcher, Astrid (2009) Chronic kidney disease and hip-fracture mortality in older people in the UK. Nephrology Dialysis Transplantation, 24 (5), 1539-1544. (doi:10.1093/ndt/gfn678).

Record type: Article

Abstract

BACKGROUND: Dialysis patients have increased hip fracture rates when compared to the general population of the same age and sex. There have been few studies of the association of earlier stages of chronic kidney disease (CKD) with hip fractures amongst older people in the general population. The aim of this study was to examine whether CKD at older ages is associated with hip-fracture-related mortality. METHODS: In a trial of health and social assessment of people aged 75 and over in the UK with baseline assessment between 1995 and 1998, there were 13 177 (87%) participants in 53 general practices who had a serum creatinine measured at baseline. Estimated glomerular filtration rate (eGFR) was derived from the modification of diet in renal disease formula (MDRD). Mortality follow-up using linkage to national mortality data was until the end of November 2005. We used propensity scores to adjust for potential confounders in Cox regression models. RESULTS: There were 84 hip-fracture-related deaths over a median follow-up of 7.25 years (IQR 3.79-8.77). Compared to eGFR 60 ml/min/1.73 m(2) and above, the age- and sex-adjusted hazard ratio (HR) for hip-fracture-related death was 1.06 (95% confidence interval: 0.71, 1.58) for eGFR 45-59 and 1.98 (1.12, 3.50) for eGFR < 45. In adjusted models, the HR for eGFR < 45 ml/min/1.73 m(2) compared to above was 1.81 (1.11, 2.96). CONCLUSIONS: Amongst older people, an eGFR of <45 ml/ min/1.73 m(2) is associated with an almost 2-fold increase in hip-fracture-related mortality

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More information

Published date: May 2009
Keywords: aged, serum, people, population, kidney, follow up, mortality data, creatinine, disease, hip fractures, mortality, general-practice, model, hip, methods, health, deaths, sex, rates, patients, london, trial, fractures, glomerular filtration rate, death, follow-up, hygiene, general practice, diet, chronic, epidemiology

Identifiers

Local EPrints ID: 70043
URI: http://eprints.soton.ac.uk/id/eprint/70043
PURE UUID: c0cbeed0-8333-459d-a8b0-a69c9ee5bc6d
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 20 Jan 2010
Last modified: 14 Mar 2024 02:38

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Contributors

Author: Dorothea Nitsch
Author: Adrian Mylne
Author: Liam Smeeth
Author: Richard Hubbard
Author: Astrid Fletcher

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