Chronic Kidney Disease Raises Fracture Risk in Children
Fracture rates are 2.4- to 3-fold higher than rates found in the general population of children and adolescents.
Children with chronic kidney disease (CKD) are at significantly higher risk of fracture compared with the general population, according to a report published online ahead of print in the Journal of the American Society of Nephrology.
Michelle R. Denberg, MD, of the Children's Hospital of Pennsylvania in Philadelphia, and colleagues conducted a prospective cohort study of 537 children and adolescents with CKD. At enrollment, the patients had a median age of 11 years, and 16% of them reported a prior fracture.
During a median of 3.9 years, 43 boys and 24 girls sustained incident fractures, or 395 and 323 fractures per 10,000 person-years, respectively. These rates are 2.4- to 3-fold higher, respectively, than gender-specific rates found in a large population-based study of fracture epidemiology in children and adolescent, Dr. Denberg's group reported.
In multivariable analysis, advanced pubertal age, greater height Z-score, difficulty walking and higher parathyroid hormone level were independently associated with greater fracture risk. Participation in more than 1 team sport was associated with a nearly 5-fold increased risk. Phosphate binder treatment was associated with a significant 63% decreased risk of fracture.