title: Incidence and risk factors for hip fractures in dialysis patients.
abstract: This study described the incidence of hip fractures, associated diseases, and related costs generated in dialysis versus non-dialysis patients.
  
  
  BACKGROUND
  Skeletal fractures are a great concern in chronic kidney disease patients and, in particular, hip fractures that enhance the mortality. We aimed to accurately determine the incidence of hip fractures and associated diseases and to calculate the costs generated in dialysis patients.
  
  
  METHODS
  We obtained data from the 2010 French National Hospital Database. We first extracted the hospital stays related to hip fractures as a primary diagnosis according to the ICD-10 codes and then the hospitalizations for dialysis. We compared the frequency of comorbidities in both populations.
  
  
  RESULTS
  Among the 88,962 patients who suffered from hip fractures, 362 were on dialysis. The incidence was significantly higher in dialysis patients (x4) compared to non-dialysis patients. Women on dialysis experienced hip fractures at an earlier age than non-dialysis women. Dementia was identified as a major risk factor in the dialysis patients (72 vs. 26%, p < 0.0001). Moreover, diabetes and cardiovascular diseases were comorbidities strongly associated with hip fractures in both gender, but hypertension and malnutrition were observed exclusively in men on dialysis. Mortality rate and length of hospital stay were increased (5 days) in both genders.
  
  
  CONCLUSIONS
  The incidence of hip fractures is increased in dialysis patients, affecting a larger percentage of men and women on dialysis than in the non-dialysis population and enhancing the financial burden and mortality. Dementia is a major risk factor for hip fractures in dialysis patients in addition to diabetes and cardiovascular diseases.
authors.affiliation: Department of Medical Information, Hôpital Léopold-Bellan, 19-21, rue Vercingétorix, 75674, Paris, Cedex 14, France, mmaravic2010@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Maravic
authors.forename: A
authors.initials: A
authors.lastname: Ostertag
authors.forename: P U
authors.initials: PU
authors.lastname: Torres
authors.forename: M
authors.initials: M
authors.lastname: Cohen-Solal
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000150:complications / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution