Men with CKD stage 4 have an elevated risk of hip fracture comparable to that of men on dialysis, data show.


Researchers at the University of Washington in Seattle studied 33,091 male veterans at eight Veterans Affairs medical centers in the northwestern United States. The men had a glomerular filtration rate (GFR) less than 60 mL/min per 1.73 m2. None had received long-term dialysis or had a previous organ transplant, cancer diagnosis, or history of hip fracture.

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The investigators identified 176 hip fractures in the study population using hospitalization codes. After adjusting for age, BMI, diabetes, and use of selected medications, men with a GFR of 30-59 and 15-29 mL/min per 1.73 m2 had a 28% and fourfold increased risk of hip fracture, respectively, compared with men whose GFR was 60 mL/min per 1.73 m2 or higher, according to a report in the American Journal of Kidney Diseases (2008;51:38-44).


The researchers estimated GFR on the basis of two or more consecutively abnormal outpatient serum creatinine measurements during a six-month period. Study findings in predominantly male Caucasian population should be confirmed in more diverse CKD populations.