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.