Trial reportClinical journal of the American Society of Nephrology : CJASN2013
Albuminuria and rapid loss of GFR and risk of new hip and pelvic fractures.
Trial report in Clinical journal of the American Society of Nephrology : CJASN, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers for preventing the progression of diabetic kidney disease.The Cochrane database of systematic reviews · 2024Pooled it
- Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers for adults with early (stage 1 to 3) non-diabetic chronic kidney disease.The Cochrane database of systematic reviews · 2023Pooled it
- Association of Increased Urinary Albumin With Risk of Incident Clinical Fracture and Rate of Hip Bone Loss: the Osteoporotic Fractures in Men Study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2017Trial
- Associations of Albuminuria and Metabolic Syndrome Traits With Fracture Risk in Patients With Type 2 Diabetes: A Population-Based Cohort Study.Journal of cachexia, sarcopenia and muscle · 2026Article
- Increased hip fracture risk in the patients with type 2 diabetes mellitus is correlated with urine albumin-to-creatinine ratio (ACR) and diabetes duration in men.Experimental biology and medicine (Maywood, N.J.) · 2024Article
- Degree of Albuminuria is Associated With Increased Risk of Fragility Fractures Independent of Estimated GFR.Kidney international reports · 2023Article
- Steroid-Associated Side Effects in Patients With Primary Proteinuric Kidney Disease.Kidney international reports · 2019Article
- Proteinuria Is Associated With Increased Risk of Fragility Fracture in Men With or at Risk of HIV Infection.Journal of acquired immune deficiency syndromes (1999) · 2019Article
- Association of Bone Mineral Density With Fractures Across the Spectrum of Chronic Kidney Disease: The Regina CKD-MBD Study.Canadian journal of kidney health and disease · 2019Article
- Association between Bone Mineral Density and Albuminuria: Cross-Sectional Analysis of Data from the 2011 Korea National Health and Nutrition Examination Survey V-2.Endocrinology and metabolism (Seoul, Korea) · 2018Article
- Systemic markers of microvascular disease and bone mineral density in older adults : The cardiovascular health study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Article
- Kidney Function and Fracture Risk: The Atherosclerosis Risk in Communities (ARIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2016Article
- Confusion about Cadmium Risks: The Unrecognized Limitations of an Extrapolated Paradigm.Environmental health perspectives · 2016Article
- Observational
- Ratio of urine albumin to creatinine attenuates the association of dementia with hip fracture risk.The Journal of clinical endocrinology and metabolism · 2014Article
- Albuminuria is associated with hip fracture risk in older adults: the cardiovascular health study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2013Article
- Urinary cadmium as a marker of exposure in epidemiological studies: Bernard and Chaumont respond.Environmental health perspectives · 2013Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 4 countries.
Funding
Abstract
BACKGROUND AND
objectivesThe microvascular circulation plays an important role in bone health. This study examines whether albuminuria, a marker of renal microvascular disease, is associated with incident hip and pelvic fractures. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This study reanalyzed data from the Ongoing Telmisartan Alone and in combination with Ramipril Global End Point Trial/Telmisartan Randomized Assessment Study in Angiotensin-Converting Enzyme Intolerant Subjects with Cardiovascular Disease trials, which examined the impact of renin angiotensin system blockade on cardiovascular outcomes (n=28,601). Albuminuria was defined as an albumin-to-creatinine ratio≥30 mg/g (n=4597). Cox proportional hazards models were used to determine the association of albuminuria with fracture risk adjusted for known risk factors for fractures, estimated GFR, and rapid decline in estimated GFR (≥5%/yr).
resultsThere were 276 hip and pelvic fractures during a mean of 4.6 years of follow-up. Participants with baseline albuminuria had a significantly increased risk of fracture compared with participants without albuminuria (unadjusted hazard ratio=1.62 [1.22, 2.15], P<0.001; adjusted hazard ratio=1.36 [1.01, 1.84], P=0.05). A dose-dependent relationship was observed, with macroalbuminuria having a large fracture risk (unadjusted hazard ratio=2.01 [1.21, 3.35], P=0.007; adjusted hazard ratio=1.71 [1.007, 2.91], P=0.05) and microalbuminuria associating with borderline or no statistical significance (unadjusted hazard ratio=1.52 [1.10, 2.09], P=0.01; adjusted hazard ratio=1.28 [0.92, 1.78], P=0.15). Estimated GFR was not a predictor of fracture in any model, but rapid loss of estimated GFR over the first 2 years of follow-up predicted subsequent fracture (adjusted hazard ratio=1.47 [1.05, 2.04], P=0.02).
conclusionsAlbuminuria, especially macroalbuminuria, and rapid decline of estimated GFR predict hip and pelvic fractures. These findings support a theoretical model of a relationship between underlying causes of microalbuminuria and bone disease.
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