Hip-Fracture-Related Death Linked to CKD in the Elderly

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Nephrol Dial Transplant. 2009;24:1539-1544

Among older individuals, an estimated glomerular filtration rate (eGFR) below 45 mL/min/1.73 m2 is associated with a nearly twofold increased risk of hip-fracture-related mortality, according to British researchers.

Dorothea Nitsch, MD, MSc, of the London School of Hygiene & Tropical Medicine in the U.K., and colleagues studied 13,167 patients aged 75 years and older (5,111 men and 8,056 women who had serum creatinine levels measured at baseline. Eighty-four deaths related to hip fracture occurred over a median follow-up of 7.25 years. Subjects with an eGFR below 45 were at 1.81 times higher risk of hip-fracture-related death compared with those with a higher eGFR, after adjusting for age, gender, and other potential confounders. In addition, 44.7% of hip-fracture-related deaths among patients with an eGFR below 45 appeared to be attributable to kidney dysfunction itself, the authors observed.

The study had a number of limitations. For example, the researchers noted that their results are based only on mortality and not on the incidence of hip fracture. In addition, they did not have a direct measure of true kidney function.
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