Prevalence of vertebral fractures and their prognostic significance in the survival in patients with chronic kidney disease stages 3-5 not on dialysis
Castro-Alonso, Cristina (Universitat de València)
D'Marco, Luis (Universitat de València)
Pomes Tallo, Jaume (Hospital Clínic i Provincial de Barcelona)
Amo Conill, Montserrat del (Hospital Clínic i Provincial de Barcelona)
García-Diez, Ana Isabel (Hospital Clínic i Provincial de Barcelona)
Molina, Pablo (Universitat de València)
Puchades, Mª Jesús (Universitat de València)
Valdivielso, José Manuel (Instituto de Salud Carlos III)
Escudero Quesada, Verónica (Universitat de València)
Bover, Jordi (Institut d'Investigació Biomèdica Sant Pau)
Navarro-González, Juan F. (Universidad de La Laguna)
Ribas, Begoña (Hospital Universitario La Paz)
Pallardo, Luis M. (Universitat de València)
Gorriz, Jose Luis (Universitat de València)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	The prevalence of vertebral fractures (VF) and their association with clinical risk factors and outcomes are poorly documented in chronic kidney disease (CKD) cohorts. The aim of the study was to evaluate the prevalence of VF in patients with non-dialysis dependent CKD (NDD-CKD), their value in predicting mortality and its correlation with parameters of bone mineral metabolism and vascular calcification. 612 NDD 3-5 stage CKD patients participating in the OSERCE-2 study, a prospective, multicenter, cohort study, were prospectively evaluated and categorized into two groups according to presence or absence of VF at enrollment. VF were assessed with lateral radiographs and Genant semi-quantitative method was applied. Three radiologists specialized in musculoskeletal radiology performed consensual reading of individual images obtained using a Raim DICOM Viewer and a Canon EOS 350 camera to measure with Java Image software in those who had traditional acetate X-ray. Factors related to VF were assessed by logistic regression analysis. Association between VF and death over a 3-year follow-up was assessed by Kaplan-Meier survival curves and Cox-proportional hazard models. VF were detected in 110patients(18%). Serumphosphatelevels(OR0. 719,95%CI0. 532to0. 972,p = 0. 032),ankle-brachial index < 0. 9 (OR 1. 694, 95% CI 1. 056-2. 717, p = 0. 029) and treatment with bisphosphonates (OR 5. 636, 95% CI 1. 876-16. 930, p = 0. 002) were independently related to the presence of VF. After a median follow-up of 35 months (IQR: 17-37 months), 62 patients (10%) died. The causes of death were cardiovascular (n = 21, 34%) and infectious (n = 11, 18%). In the crude analysis, fractured patients group had poorer survival (log-rank test, p = 0. 02). After multivariate adjustment for age, MDRD, albumin, diabetes mellitus, comorbidity, Adragao Score.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Chronic kidney disease ; Fractures ; Vascular calcification
Publicat a:	Journal of clinical medicine, Vol. 9 Núm. 5 (may 2020) , p. 1-11, ISSN 2077-0383

DOI: 10.3390/JCM9051604
PMID: 32466297

11 p, 1.0 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Articles > Articles de recerca
Articles > Articles publicats