Evidence map›Paper›PMID 32483674›Full record

ArticleArchives of osteoporosis2020

Alendronate use and bone mineral density gains in women with moderate-severe (stages 3B-5) chronic kidney disease: an open cohort multivariable and propensity score analysis from Funen, Denmark.

M Sanni Ali, Martin Ernst, Danielle E Robinson, Fergus Caskey, Nigel K Arden, Yoav Ben-Shlomo, Mads Nybo, Katrine H Rubin, Andrew Judge, Cyrus Cooper and 3 more

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Archives of osteoporosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.5field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Global, regional, and national burden of vertebral fractures among women from 1990 to 2021: a systematic analysis based on the global burden of disease study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
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  2. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 4 countries.

M Sanni Ali *Faculty of Epidemiology and Population Health, Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Martin Ernst *OPEN, Department of Health, University of Southern Denmark, Odense, Denmark.
Danielle E RobinsonCenter for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Fergus CaskeyPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Nigel K ArdenNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Yoav Ben-ShlomoPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Mads NyboDepartment of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
Katrine H RubinOPEN, Department of Health, University of Southern Denmark, Odense, Denmark.
Andrew JudgePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Cyrus CooperNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
M K JavaidNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Anne P HermannDepartment of Endocrinology, Odense University Hospital, Odense, Denmark.
Daniel Prieto-AlhambraCenter for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. daniel.prietoalhambra@ndorms.ox.ac.uk.
Nuffield Orthopaedic Centre · GBOdense University Hospital · DKUniversity of Bristol · GBUniversity of Southern Denmark · DKUniversitat Autònoma de Barcelona · ES

Funding

Department of Health 10/33/04Medical Research Council G0400491Medical Research Council MC_U147585819Medical Research Council MC_U147585824Medical Research Council MC_U147585827Medical Research Council MC_UP_A620_1014Medical Research Council MC_UP_A620_1015Medical Research Council MC_UU_12011/1Medical Research Council MC_UU_12011/2
6 · The paper itself

Abstract

Bisphosphonates are contraindicated in moderate-to-severe chronic kidney disease patients. However, they are used to prevent fragility fractures in patients with impaired kidney function, despite a lack of evidence on their effects on bone density in these patients. We demonstrated that Alendronate had a positive effect on bone in these patients. PURPOSE: This study aimed to assess the association between alendronate use and bone mineral density (BMD) change in subjects with moderate-severe chronic kidney disease (CKD).

methodsWe created a cohort of CKD stage 3B-5 patients by linking all DXA-based measurements in the Funen area, Denmark, to biochemistry, national health registries and filled prescriptions. Exposure was dispensation of alendronate and the outcome was annualized percentage change in BMD at the femoral neck, total hip and lumbar spine. Individuals were followed from first BMD to the latest of subsequent DXA measurements. Alendronate non-users were identified using incidence density sampling and matched groups were created using propensity scores. Linear regression was used to estimate average differences in the annualized BMD.

resultsUse of alendronate was rare in this group of patients: propensity score matching (PSM) resulted in 71 alendronate users and 142 non-users with stage 3B-5 CKD (as in the 1 year before DXA). Whilst alendronate users gained an average 1.07% femoral neck BMD per year, non-users lost an average of 1.59% per annum. The PSM mean differences in annualized BMD were + 2.65% (1.32%, 3.99%), + 3.01% (1.74%, 4.28%) and + 2.12% (0.98%, 3.25%) at the femoral neck, total hip and spine BMD, respectively, all in favour of alendronate users.

conclusionIn a real-world cohort of women with stage 3B-5 CKD, use of alendronate appears associated with a significant improvement of 2-3% per year in the femoral neck, total hip and spine BMD. More data are needed on the anti-fracture effectiveness and safety of bisphosphonate therapy in moderate-severe CKD.

Indexed as

Renal Insufficiency, ChronicAlendronateBone DensityBone Density Conservation AgentsDenmarkFemaleHumansPropensity ScoreAlendronateBone Density Conservation AgentsAlendronateBone mineral densityChronic kidney diseaseIncidence density samplingOsteoporosisPropensity score

Identifiers

PMID32483674
PMCPMC8448716
OpenAlexW3022433371

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.