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Charlson C o‐morbidity I ndex and albumin significantly associated with fracture risk in peritoneal dialysis patients
Author(s) -
Ma Maggie KM,
Yap Desmond YH,
Yip Terence PS,
Lui Sing Leung,
Lo Wai Kei
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12056
Subject(s) - medicine , peritoneal dialysis , continuous ambulatory peritoneal dialysis , odds ratio , dialysis , incidence (geometry) , ambulatory , surgery , risk factor , femoral neck , osteoporosis , physics , optics
Published literature on fracture in dialysis patients seldom addressed the effect of co‐morbidity and malnutrition. In this study, we reported the incidence and risk factors for fracture in peritoneal dialysis patients. Peritoneal dialysis patients who had fractures between 2006 and 2011 were recruited. Demographic data, details of fracture, Charlson C o‐morbidity I ndex ( CCI ) and biochemical parameters were also collected. Non‐fracture controls, matched for age, gender and duration of dialysis, were also recruited at ratio 1:1 for fracture risk analysis. The incidence of fracture was 1 in 37 patient‐years. The commonest site of fracture was neck of femur ( n = 16, 55.2%). Twenty‐four patients (82.8%) developed fracture after slip and fall injury. Eight out of 17 self‐ambulatory patients (47.1%) became non‐ambulatory after fracture. Infection was the commonest complication during hospitalization. Univariant analysis demonstrated high CCI ( P = 0.001), hypoalbuminaemia ( P < 0.001), loss of self autonomy ( P = 0.006) and non‐ambulatory state ( P = 0.011) significantly associated with increased fracture risk. However, only CCI (odds ratio ( OR ) 1.373, P = 0.028) and albumin ( OR 0.893, P = 0.025) increased fracture risk significantly on multivariant analysis. Bone profile and parathyroid hormone were not significant risk factors. To conclude, fracture associated with adverse outcome in peritoneal dialysis patients. High CCI score and hypoalbuminaemia significantly increase risk of fracture.