Fractures are more common among children with glomerular disease, especially girls, compared with the general pediatric population, according to investigators.
In a study comparing 4598 children with glomerular disease and 553,624 patients in the general pediatric population, girls with glomerular disease were 1.6 times more likely than those in the general pediatric cohort to experience any type of fracture, a team led by Michelle Denburg, MD, of the Children’s Hospital of Philadelphia in Pennsylvania, reported in the Journal of the American Society of Nephrology. The difference between boys with glomerular disease and those in the general pediatric cohort was not statistically significant.
“This sex difference warrants further investigation and could be due to differential effects of glomerular disease on bone quality in girls versus boys,” Dr Denburg and colleagues wrote. “Sex differences in growth-related indices of bone quality, such as greater bone size and strength across growth in boys, may render girls more vulnerable to the effects of glomerular disease.”
In analyses adjusted for sex, race, age, and obesity, however, the children with glomerular disease were 5.0 times and 2.2 times more likely to experience vertebral fractures and hip/femur fractures, respectively, compared with the general pediatric cohort. The glomerular disease cohort also had a greater likelihood of avascular necrosis/osteonecrosis and slipped capital femoral epiphysis.
The investigators also compared a subgroup of 2238 patients who had nephrotic conditions with the general pediatric cohort. Girls with nephrotic conditions were 1.6 times more likely to experience a fracture of any kind compared with girls in the general pediatric population, whereas no difference in the likelihood of fracture was observed among boys.
Davies AJG, Xiao R, Razzaghi H, et al. Skeletal outcomes in children and young adults with glomerular disease. J Am Soc Nephrol. Published online September 28, 2022. doi:10.1681/ASN.2021101372