Prevalence of osteoporosis in patients with chronic kidney disease (stages 3–5) in comparison with age- and sex-matched controls: A study from Kashmir Valley Tertiary Care Center

Abstract

Chronic kidney disease (CKD) is associated with a range of metabolic bone diseases. Fracture rates are higher in CKD patients than age-matched controls throughout all the five stages of CKD. Dialysis patients have 4 times as many hip fractures as expected for their age. CKD forms an independent risk factor for osteoporosis, even in the absence of traditional risk factors. This study was carried out at the nephrology unit in a tertiary care center of Kashmir to know the prevalence of osteoporosis in CKD patients having glomerular filtration rate (GFR) <60 mL/min (stages 3-5). Among the 151 cases studied, the average estimated GFR was 16.78 ± 10.714 mL/min. There were 98 males (64.9%) and 53 females (35.1%). Their mean age was 51.01 ± 14.138 years. Osteoporosis based on femoral neck T-Score was seen in 31 patients (31.6%) while 43 patients (28.5%) had osteoporosis at L1, L2 lumbar vertebrae. The prevalence of osteoporosis based on femoral neck T-Score as well as osteopenia was highest in stage-5 CKD. In our study, the body mass index (BMI) had a positive correlation with osteoporosis; low BMI patients were at higher risk for osteoporosis (P = 0.014). In the Kashmir valley, the prevalence of osteoporosis was 31.8% in CKD patients against 22% in controls. Thus, CKD forms an important risk factor for osteoporosis even in the absence of traditional risk factors. We recommend early screening, detection, and management of osteoporosis to reduce the burden of morbidity and mortality in this subset of patients.

Chronic kidney disease can increase the risk of preoperative deep vein thrombosis in middle-aged and elderly patients with hip fractures

“…CKD has an increasing prevalence in the general population and is a frequent comorbidity in patients with hip fractures. 9 , 18 In our study, the prevalence of patients with eGFR <60 mL/min/1.73 m 2 was 6.0% (n=15), and our study showed that eGFR was an independent factor of preoperative DVT in patients with hip fractures. Patients with CKD had a higher increased risk of occurrence of preoperative DVT than those with normal kidney function, which was consistent with data from previous studies.…”

“…Renal insufficiency is a common comorbid disease and is associated with a range of metabolic bone diseases; it is especially common among elderly patients with hip fractures. 9 Renal insufficiency typically results in the occurrence of chronic kidney disease (CKD), and patients with CKD usually experience increased rates of morbidity and mortality. 10 Autonomic dysfunction, myocyte dysfunction, altered electrolyte metabolism, and cardiac fibrosis may contribute to cardiovascular disease in patients with CKD, which is the leading cause of morbidity and mortality in this population.…”

Iron Deficiency and Iron Deficiency Anemia: Potential Risk Factors in Bone Loss

“…Osteoporosis or osteopenia is another common complication of CKD. The prevalence of osteoporosis in CKD patients ranged from 18% to 32%, while osteopenia was found in up to 57% of patients [ 58 , 59 ]. A significantly higher prevalence of osteoporosis and fractures has been reported in patients with end-stage renal disease (ESKD), especially in patients on hemodialysis compared to those on peritoneal dialysis [ 60 ].…”

Causal Effects of Genetically Predicted Cystatin C on Osteoporosis: A Two-Sample Mendelian Randomization Study

“…Therefore, early diagnosis and prevention are extremely important. Studies have shown that chronic kidney disease (CKD) is an independent risk factor for osteoporosis (Najar et al, 2017). Patients with renal insufficiency have a significantly lower bone mineral density (BMD) (Tseng et al, 2014;Bezerra de Carvalho et al, 2019).…”