Evidence map›Paper›PMID 42034804›Full record

Observational studyClinical and experimental nephrology2026

Association of osteoporosis treatment with risk of fracture, cardiovascular disease, and all-cause mortality in patients on maintenance dialysis: a retrospective database study using real-world data in Japan.

Yasuo Imanishi, Kanae Takahashi, Hisako Yoshida, Ryota Kawai, Yuki Eguchi, Kengo Saito, Yu Sadachi, Ayumi Shintani

Abstract readObservational Study
In one paragraph

Observational study in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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.

Yasuo ImanishiDepartment of Vascular Medicine, Vascular Science Center for Translational Research, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan. imanishig@gmail.com.
Kanae TakahashiDepartment of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.
Hisako YoshidaDepartment of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.
Ryota KawaiDepartment of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.
Yuki EguchiPrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd., 3-5-1 Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.
Kengo SaitoPrimary Medical Science Department, Medical Affairs Division, Daiichi Sankyo Co., Ltd., 3-5-1 Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.
Yu SadachiData Intelligence Department, Global DX, Daiichi Sankyo Co., Ltd., 1-2-58 Hiromachi, Shinagawa-ku, Tokyo, Japan.
Ayumi ShintaniDepartment of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with chronic kidney disease who have progressed to dialysis treatment have increased fracture risk. However, the impact of osteoporosis treatment on fracture risk has not been evaluated in a large-scale study using Japanese real-world data.

methodsIn this retrospective observational study (UMIN000054749), DeSC-IQVIA Integrated Claims Data were used to investigate the impact of osteoporosis treatment on fracture risk and other events in patients receiving maintenance hemo- or peritoneal dialysis. Data from April 2014 to August 2022 were extracted, and patients were divided into treated/untreated groups based on prescription records for osteoporosis medications during a 1-year exposure assessment period. The primary endpoint was the incidence of total and hip fractures from the index date (1 year post-exposure assessment period) until the end of follow-up.

resultsOf 156,557 patients receiving maintenance dialysis for ≥ 1 year, 38,246 were included: 1093 and 37,153 in the treated and untreated groups, respectively. Although there was a numerically higher fracture incidence in the treated group, no significant difference was observed between the groups overall. As aged, the difference in fracture risk between the groups decreased. Multivariable regression analysis revealed that age, sex, fracture history (primary risk factor), diabetes, and sleep disorder were statistically significant effect modifiers of fracture risk.

conclusionThe numerically higher incidence of fractures in the treated group may have been due to patient background differences. Fracture risk management is essential in dialysis patients, and osteoporosis treatment should be considered at an earlier age, taking into account the patient's background.

Indexed as

Bone Density Conservation AgentsCardiovascular DiseasesFractures, BoneOsteoporosisRenal DialysisRenal Insufficiency, ChronicAgedAged, 80 and overDatabases, FactualFemaleHip FracturesHumansIncidenceJapanMaleMiddle AgedBone Density Conservation AgentsCardiovascular diseaseDialysisFractureMortalityOsteoporosisReal-world evidence

Identifiers

PMID42034804
PMCPMC13291016

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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.