Journal article
Trabecular bone score in patients with chronic kidney disease.
- Rampersad C Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. umrampec@myumanitoba.ca.
- Whitlock RH Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- Leslie WD Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- Rigatto C Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- Komenda P Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- Bohm C Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- Hans D Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Tangri N Rady Faculty of Health Sciences, University of Manitoba, GF324-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada.
- 2020-05-23
Published in:
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. - 2020
English
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.
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.
- Language
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- English
- Open access status
- closed
- Identifiers
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- DOI 10.1007/s00198-020-05458-1
- PMID 32440892
- Persistent URL
- https://sonar.ch/global/documents/278310
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