Hip fracture in patients with non‐dialysis‐requiring chronic kidney disease

SM Kim, J Long, M Montez‐Rath… - Journal of Bone and …, 2016 - academic.oup.com
SM Kim, J Long, M Montez‐Rath, M Leonard, GM Chertow
Journal of Bone and Mineral Research, 2016academic.oup.com
Patients with end‐stage renal disease (ESRD) are at a high risk for hip fracture. Little is
known about the risk for, and consequences of, hip fracture among patients with non‐
dialysis‐requiring chronic kidney disease (CKD). We examined the incidence of hip fracture,
in‐hospital mortality, length of stay, and costs among patients with ESRD, non‐dialysis‐
requiring CKD, and normal or near normal kidney function. Using the Healthcare Cost and
Utilization Project's Nationwide Inpatient Sample, a nationally representative database, we …
Abstract
Patients with end‐stage renal disease (ESRD) are at a high risk for hip fracture. Little is known about the risk for, and consequences of, hip fracture among patients with non‐dialysis‐requiring chronic kidney disease (CKD). We examined the incidence of hip fracture, in‐hospital mortality, length of stay, and costs among patients with ESRD, non‐dialysis‐requiring CKD, and normal or near normal kidney function. Using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, a nationally representative database, we identified hospitalizations for hip fracture in 2010. We incorporated data from the United States Renal Data System (USRDS) and the US census to calculate population‐specific rates. Age‐standardized incidence of hip fracture was highest among patients with ESRD (3.89/1000 person‐years), followed by non‐dialysis‐requiring CKD (1.81/1000 persons) and patients with normal or near normal kidney function (1.18/1000 persons). In‐hospital mo rtality (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.46 to 1.96), lengths of stay (median [10th, 90th percentiles] 5 [3 to 11] versus 5 [3 to 10] days) and costs (median $14,807 versus $13,314) were significantly higher in patients with non‐dialysis‐requiring CKD relative to patients with normal or near normal kidney function. In summary, non‐dialysis‐requiring CKD is associated with higher age‐standardized rates of hip fracture and post‐hip fracture mortality and higher resource utilization. © 2016 American Society for Bone and Mineral Research.
Oxford University Press