Independent from muscle power and balance performance, a creatinine clearance below 65 ml/min is a significant and independent risk factor for falls and fall-related fractures in elderly men and women diagnosed with osteoporosis.
We assessed in a cross-sectional study in elderly men and women with osteoporosis, the association between the creatinine clearance (CrCl) and the performance in different balance and muscle power and function tests and found that a decreasing creatinine clearance was significantly associated with lower balance and muscle power.


BACKGROUND
To determine if a creatinine clearance of <65 ml/min is significantly associated with decreasing muscle power and balance and an increased risk for falls and fractures.


METHODS
We assessed in a cross-sectional-study in 1781 German osteoporotic patients, the association between the CrCl, the physical performance, and the number of falls and fractures.


RESULTS
Controlling for age, gender, BMI, and osteoporosis treatment (fracture analysis only), a decreasing CrCl was associated with lower physical performance in the timed-up-and-go test (corr -0.2337, P < 0.0001), chair-rising test (corr -0.1706, P < 0.001), and tandem-stand test (corr 0.2193, P < 0.0001), and a CrCl of <65 ml/min was associated with a significantly higher risk for falls (47.7% vs. 36.2%, P = 0.0008) and fall-related fractures (33.1% vs. 22.9%, P = 0.0003) compared with a CrCl of >or=65 ml/min.


CONCLUSIONS
In this study, we found a significant gender-independent correlation between decreasing CrCl and lower performance in balance and muscle power tests. Reduced muscle power and balance may therefore be involved in the low creatinine clearance associated increased risk for falls and fall-related fractures. Furthermore, we found that a CrCl <65 ml/min., independent from the performance in muscle power, muscle function, and balance tests, is a significant risk factor for falls and fractures.
Dukas
L
L
Department of Medicine, Acute Geriatric University Clinic, Basel, Switzerland. l.d@gmx.net
Schacht
E
E
Runge
M
M
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D010024:Osteoporosis / Q000097:blood; D058866:Osteoporotic Fractures / Q000097:blood / Q000209:etiology*; D004856:Postural Balance / Q000502:physiology*; D012307:Risk Factors
D003404:Creatinine