Evidence map›Paper›PMID 34994816›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2022

Magnesium exposure increases hip fracture risks in patients with chronic kidney disease: a population-based nested case-control study.

Y-T Chen, Z-K Kao, C-J Shih, S-M Ou, C-Y Yang, A-H Yang, O K-S Lee, D-C Tarng

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Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.6field-weighted citation impact, top 40% 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

4 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 3 countries.

Y-T ChenDivision of Nephrology, Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, 10065, Taiwan.
Z-K KaoInstitute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Room 208, Shou-Ren Building, No.155, Section 2, Li-Nong Street, Beitou District, Taipei, 11221, Taiwan.
C-J ShihFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
S-M OuFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
C-Y YangFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan. cyyang3@vghtpe.gov.tw.ORCID http://orcid.org/0000-0001-9899-3159
A-H YangFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
O K-S LeeFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
D-C TarngFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan.
National Yang Ming Chiao Tung University · TW

Funding

Ministry of Education Center for Intelligent Drug SystemsMinistry of Education Smart Bio-devices (IDS2B)Ministry of Science and Technology, Taiwan MOST 105-2628-B-075-008-MY3Ministry of Science and Technology, Taiwan MOST 108-2813-C-010-034-BMinistry of Science and Technology, Taiwan MOST 108-2923-B-010-002-MY3Ministry of Science and Technology, Taiwan MOST 109-2314-B-010-053-MY3Ministry of Science and Technology, Taiwan MOST 109-2811-B-010-532Ministry of Science and Technology, Taiwan MOST 109-2823-8-010-003-CVMinistry of Science and Technology, Taiwan MOST 109-2926-I-010-502Ministry of Science and Technology, Taiwan MOST 110-2321-B-A49-003Ministry of Science and Technology, Taiwan MOST 110-2811-B-010-510Ministry of Science and Technology, Taiwan MOST 110-2813-C-A49A-551-BMinistry of Science and Technology, Taiwan MOST 110-2923-B-A49A-501-MY3National Yang-Ming University 107F-M01-0510)National Yang-Ming University Construction Plan (107F-M01-0504National Yang-Ming University Yin Yen-Liang Foundation DevelopmentTaipei Veterans General Hospital V106D25-003-MY3Taipei Veterans General Hospital V110C-194Taipei Veterans General Hospital VGHUST107-G5-3-3Taipei Veterans General Hospital VGHUST109-V5-1-2
6 · The paper itself

Abstract

This population-based study demonstrates a strong link between Mg-containing antacid exposure and hip fracture risk in nondialysis CKD and dialysis patients. As an Mg-containing antacid, MgO is also commonly used as a stool softener, which can be effortlessly replaced by other laxatives in CKD patients to maintain bone health. PURPOSE: Bone fracture is a severe complication in chronic kidney disease (CKD) patients, leading to disability and reduced survival. In CKD patients, blood magnesium (Mg) concentrations are usually above the normal range due to reduced kidney excretion of Mg. The present study examines the association between Mg-containing antacid exposure and the risk of hip fracture of CKD patients.

methodsIn this nationwide nested case-control study, we enrolled 44,062 CKD patients with hip fracture and 44,062 CKD matched controls, among which the mean age was 77.1 years old, and 87.9% was nondialysis CKD.

resultsAs compared to non-users, Mg-containing antacid users were significantly more likely to experience hip fracture (adjusted odds ratio (OR) 1.36, 95% CI, 1.32 to 1.41; p < 0.001). Subgroup analysis showed that such risk exists in both nondialysis CKD patients and long-term dialysis patients. In contrast, aluminum or calcium-containing-antacid use did not reveal such association. Next, we examined the influence of Mg-containing antacid dosage on hip fracture risk, the adjusted ORs in the first quartile (Q1), Q2, Q3, and Q4 were 1.20 (95% CI, 1.15 to 1.25; p < 0.001), 1.35 (95% CI, 1.30 to 1.41; p < 0.001), 1.49 (95% CI, 1.43 to 1.56; p < 0.001), and 1.54 (95% CI, 1.47 to 1.61; p < 0.001), respectively, showing that such risk exists regardless of the antacid dosage. A receiver operating characteristic curve analysis demonstrated that the best cutoff value of the exposed Mg dose to discriminate the hip fracture is 532 mEq during the follow-up period.

conclusionThis population-based study demonstrates a strong link between Mg-containing antacid exposure and the hip fracture risk in both nondialysis CKD and dialysis patients.

Indexed as

Hip FracturesRenal Insufficiency, ChronicAgedAntacidsCase-Control StudiesFemaleHumansMagnesiumMaleRisk FactorsAntacidsMagnesiumAntacidBone mineralizationChronic kidney diseaseFractureMagnesium

Identifiers

PMID34994816
OpenAlexW4206108229

What OpenQuestion holds

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Registered trials

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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.