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Vertebral fracture linked to myocardial infarction risk in hemodialysis patients

Key clinical point: Fracture, especially vertebral fracture occurrence, is significantly associated with the risk of myocardial infarction (MI) in hemodialysis (HD) patients.

Major finding: Multiple logistic regression analysis revealed that fracture occurrence significantly correlated with MI in the HD group (odds ratio [OR], 1.34; P = .024), but not in the predialysis chronic kidney disease (CKD) group (OR, 1.04; P = .701). In addition, propensity score-matching analysis showed similar results. In the subgroup analysis by fracture site, vertebral fracture was significantly associated with MI in HD patients (OR, 2.11; P = .024).

Study details: This retrospective, Korean population-based cohort study included 38,935 patients (HD, n = 11,379; predialysis CKD, n = 27,556).

Disclosures: This study was supported by a research grant from the Korean Society of Nephrology. The authors declared no conflicts of interest.

Commentary

"Mineral and bone disorder (MBD) is associated with fractures and represents a major complication of chronic kidney disease (CKD). This retrospective study of almost 40,000 people with CKD examined the association between fracture and myocardial infarction (MI) in people with CKD. People with CKD on hemodyalisis and fractures, identified using diagnostic codes, had 34% higher odds of MI compared to those who did not have fractures. The odds of MI were even higher in people who had vertebral fractures (OR[95%CI] 2.11[1.10–4.02]. These findings demonstrated that the occurrence of fracture among people on hemodyalisis was significantly associated with MI, particularlly for vertebral fracture."

Maria I. Danila, MD, MSc, MSPH
University of Alabama at Birmingham

Citation:

Kwon YE et al. Osteoporos Int. 2020 May 11. doi: 10.1007/s00198-020-05423-y