title: Trends in hip fracture rates in US hemodialysis patients, 1993-2010.
abstract: BACKGROUND
  Changes in mineral and bone disorder treatment patterns and demographic changes in the dialysis population may have influenced hip fracture rates in US dialysis patients in 1993-2010.
  
  
  METHODS
  Retrospective follow-up study analyzing trends over time in hospitalized hip fracture rates.
  
  
  METHODS
  Using Medicare data, we created 2 point-prevalent study cohorts for each study year. Hemodialysis cohorts included patients with Medicare as primary payer receiving hemodialysis in the United States on January 1 of each year; non-end-stage renal disease (ESRD) cohorts included Medicare beneficiaries 66 years or older on January 1 of each year.
  
  
  METHODS
  Age, sex, race, primary cause of ESRD, dual Medicare/Medicaid enrollment status, comorbid conditions.
  
  
  RESULTS
  Hip fracture rates.
  
  
  METHODS
  Unadjusted hip fracture rates measured using number of events per 1,000 person-years in each year, then adjusted for patient characteristics. Poisson models estimated strata-specific event rates.
  
  
  RESULTS
  The observed number of first hospitalized hip fracture events and the adjusted hip fracture rate increased steadily from 1993 (831 events; 11.9/1,000 person-years), peaked in 2004 (3,256 events; 21.9/1,000 person-years), and decreased through 2010 (2,912 events; 16.6/1,000 person-years). The trend for the subset of hemodialysis patients 66 years or older was similar to the trend for the full hemodialysis cohort; however, it differed markedly in magnitude and pattern from the non-ESRD Medicare cohort, for which rates were substantially lower and slowly decreasing since 1996.
  
  
  CONCLUSIONS
  Unable to provide causal explanations for observed changes; hip fractures identified through inpatient episodes; results do not describe hemodialysis patients without Medicare Parts A and B; laboratory values unavailable in the Medicare data set.
  
  
  CONCLUSIONS
  Temporal trends in hip fracture rates among Medicare hemodialysis patients differ markedly from the steadily decreasing trend in non-ESRD Medicare beneficiaries, showing a relatively rapid increase until 2004 and relatively rapid decrease thereafter. Further research is needed to define associated factors.
authors: Chronic Disease Research Group, Minneapolis Medical Research Foundation, Minneapolis, MN. Electronic address: tarne18293@aol.com.
authors: Thomas J
authors: TJ
authors: Arneson
authors: Shuling
authors: S
authors: Li
authors: Jiannong
authors: J
authors: Liu
authors: Ryan D
authors: RD
authors: Kilpatrick
authors: Britt B
authors: BB
authors: Newsome
authors: Wendy L
authors: WL
authors: St Peter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D014481:United States
keywords: Hemodialysis; hip fracture rates; mineral and bone disorder