The Comparison of Hip Fracture Incidence Densities in ESRD Patients with Various Types of Renal Replacement Therapy
Abstract
Background: Chronic kidney disease is a high incidence in Thailand. long period patients with the disease have a chance for abnormal bone which known as “Chronic kidney disease-mineral and bone disorder” (CKD-MBD). ESRD patients who does non renal replacement therapy has risk of hip fractures, resulting in prolonged hospitalization, disability and death.
Objective: To compare hip fracture incidence in ESRD patients with various types of renal replacement therapy and compare hazard ratio of hip fracture events in each group.
Study design: Prognostic factor research, Retrospective Cohort studies, studied in the patients with 1st diagnosis ESRD from January 2014 to December 2016 at Phrae hospital. Compare incidence density of hip fractures in each group. Compare time-to-events in each group and analyzing Hazard ratio in each group.
Results: The non-renal replacement therapy group had the highest incidence of hip fractures due to falls. Followed by hemodialysis group with an incidence density of 7.38 and 4.31 per 1,000 person-year, respectively. When analyzed by Poisson regression, the adjusted Hazard ratio of the hemodialysis group compared with non-renal replacement therapy group was 0.90 (95% CI; 0.21-3.39) times but without statistic significant.
Conclusions: ESRD patients with types of renal replacement therapy have risk of hip fractures particularly non-renal replacement therapy group more likely higher risk than other groups. Therefore the ESRD patients need to be advised to prevent falls.
Keywords: End stage renal disease, Renal replacement therapy, Hemodialysis, Peritoneal dialysis, Hip fractures
