TY - JOUR T1 - Association of kidney function with incident hip fracture in older adults. JF - J Am Soc Nephrol Y1 - 2007 A1 - Fried, Linda F A1 - Biggs, Mary Louise A1 - Shlipak, Michael G A1 - Seliger, Stephen A1 - Kestenbaum, Bryan A1 - Stehman-Breen, Catherine A1 - Sarnak, Mark A1 - Siscovick, David A1 - Harris, Tamara A1 - Cauley, Jane A1 - Newman, Anne B A1 - Robbins, John KW - Aged KW - Aged, 80 and over KW - Cystatin C KW - Cystatins KW - Female KW - Hip Fractures KW - Humans KW - Kidney KW - Kidney Failure, Chronic KW - Longitudinal Studies KW - Male KW - Osteoporosis KW - Prospective Studies KW - Risk Factors KW - Sex Factors AB -

Kidney dysfunction is associated with bone loss, and patients with ESRD have an increased risk for hip fracture. However, the association of mild to moderate kidney disease with hip fracture has not been studied previously. The association of kidney function with incident hip fracture was examined among participants in the Cardiovascular Health Study, a community-based cohort of older individuals. The primary measure of kidney function was serum cystatin C, a measure that does not depend on lean mass. Hip fractures were identified using International Classification of Diseases, Ninth Revision codes for hospitalizations. A total of 4699 individuals had cystatin C measured in 1992 to 1993 and did not have a hip fracture before cystatin C measurement. The association of kidney function with hip fracture was analyzed with Cox proportional hazards models. Analyses were conducted separately for men and women. After a mean follow-up of 7.1 yr, 195 incident hip fractures occurred in women and 79 occurred in men. Higher cystatin C levels were associated with a higher risk for fracture in women (hazard ratio [HR] 1.26; 95% confidence interval [CI] 1.14 to 1.38 per SD) and in men (HR 1.27; 95% CI 1.11 to 1.46). After multivariable adjustment, higher cystatin C levels were significantly associated with hip fracture in women (HR 1.16; 95% CI 1.01, 1.33) but not in men (HR 1.14; 95% CI 0.86 to 1.52), although the magnitude of the association was similar. Kidney dysfunction, as assessed by cystatin C, is associated with an increased risk for hip fracture. Further studies are needed to evaluate potential mediators of this relationship and to assess whether interventions can decrease this risk.

VL - 18 IS - 1 U1 - https://www.ncbi.nlm.nih.gov/pubmed/17167115?dopt=Abstract ER -