ArticleAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016
Kidney Function and Fracture Risk: The Atherosclerosis Risk in Communities (ARIC) Study.
Article in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 65 citations in OpenAlex.
- The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Pooled it
- Efficacy and safety of empagliflozin in older patients in the EMPA-REG OUTCOME® trial.Age and ageing · 2019Trial
- 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
- Preterm birth and birth weight extremes are associated with periodontal disease and tooth loss in the ARIC study.Scientific reports · 2026Article
- The prevalence and burden of chronic kidney disease, patterns of anticoagulation prescribing, and major bleeding risk in older adults with atrial fibrillation.BMC geriatrics · 2025Article
- Preoperative rehabilitation and in-hospital mortality in delayed hip fracture surgery: a nationwide cohort study with stratification by kidney function.BMC geriatrics · 2025Article
- Lower serum magnesium levels are associated with a higher risk of fractures and vascular calcifications in hemodialysis patients.Clinical kidney journal · 2025Article
- Population Pharmacokinetic Model of Vitamin DInternational journal of molecular sciences · 2024Article
- Cystatin C is associated with osteoporosis and fractures: An observational study based on Mendelian randomization analysis.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Observational
- CKD Prevalence and Incidence in Older Adults Using Estimated GFR With Different Filtration Markers: The Atherosclerosis Risk in Communities Study.Kidney medicine · 2024Article
- Association of estimated glomerular filtration rate with prostate cancer risk in a cross-ethnic population: a Mendelian randomization study.BMC urology · 2024Article
- 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
- Proteinuria screening and risk of bone fracture: a retrospective cohort study using a nationwide population-based database.Clinical kidney journal · 2024Article
- Degree of Albuminuria is Associated With Increased Risk of Fragility Fractures Independent of Estimated GFR.Kidney international reports · 2023Article
- Incident vertebral fracture and longitudinal BMD change in Chinese postmenopausal women with early CKD: Peking Vertebral Fracture Study.Archives of osteoporosis · 2023Article
- Association between cause of kidney failure and fracture incidence in a national US dialysis population cohort study.Clinical kidney journal · 2022Article
- Type 2 diabetes and bone fragility in children and adults.World journal of diabetes · 2022Review
- Testosterone Deficiency as One of the Major Endocrine Disorders in Chronic Kidney Disease.Nutrients · 2022Review
- Risk Factors for Fracture in Patients with Coexisting Chronic Kidney Disease and Type 2 Diabetes: An Observational Analysis from the CREDENCE Trial.Journal of diabetes research · 2022Observational
- Ankle-Brachial Index and Subsequent Risk of Severe Ischemic Leg Outcomes: The ARIC Study.Journal of the American Heart Association · 2021Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundPeople with end-stage renal disease are at high risk for bone fracture. Less is known about fracture risk in milder chronic kidney disease and whether chronic kidney disease-associated fracture risk varies by sex or assessment with alternative kidney markers. STUDY
designProspective cohort study. SETTING &
participants10,955 participants from the Atherosclerosis Risk in Communities (ARIC) Study followed up from 1996 to 2011. PREDICTOR: Kidney function as assessed by creatinine-based estimated glomerular filtration rate (eGFRcr), urine albumin-creatinine ratio, and alternative filtration markers. OUTCOMES: Fracture-related hospitalizations determined by diagnostic code. MEASUREMENTS: Baseline kidney markers; hospitalizations identified by self-report during annual telephone contact and active surveillance of local hospital discharge lists.
resultsMean age of participants was 63 years, 56% were women, and 22% were black. During a median follow-up of 13 years, there were 722 incident fracture-related hospitalizations. Older age, female sex, and white race were associated with higher risk for fracture (P<0.001). The relationship between eGFRcr and fracture risk was nonlinear: <60mL/min/1.73m(2), lower eGFRcr was associated with higher fracture risk (adjusted HR per 10mL/min/1.73m(2) lower, 1.24; 95% CI, 1.05-1.47); there was no statistically significant association for ≥60mL/min/1.73m(2) in the primary analysis. In contrast, there was a graded association between other markers of kidney function and subsequent fracture, including albumin-creatinine ratio (HR per doubling, 1.10; 95% CI, 1.06-1.14), cystatin C-based eGFR (HR per 1-SD decrease, 1.15; 95% CI, 1.06-1.25), and 1/β2-microglobulin (HR per 1-SD decrease, 1.26, 95% CI, 1.15-1.37). LIMITATIONS: No bone mineral density assessment; one-time measurement of kidney function.
conclusionsBoth low eGFR and higher albuminuria were significant risk factors for fracture in this community-based population. The shape of the association in the upper ranges of eGFR varied by the filtration marker used in estimation.
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