title: Increased risk of end-stage renal disease among hip fracture patients.
abstract: BACKGROUND
  Inflammation-related microvasculr disease, albuminuria, and rapid deterioration of renal function can accelerate the development of end-stage renal disease (ESRD). The role of hip fracture (HFr), a disorder that involves inflammation, in the development of ESRD has not been fully investigated. This study explored whether HFr increases the risk of ESRD.
  
  
  METHODS
  Taiwan National Health Insurance inpatient claims were used to identify 83,550 patients newly diagnosed with HFr from 2000 to 2006, and 83,550 age- and sex-matched patients without HFr were randomly selected for comparison. Hazards of ESRD combined with HFr, comorbidities, including hypertension, hyperlipidemia, peripheral arterial disease, osteoporosis and asthma, and general health status, with Charlson comorbidity index (CCI), were assessed using data to the end of 2011.
  
  
  RESULTS
  ESRD risk was 1.42-fold higher (95% confidence interval [CI]:1.29-1.33) in the HFr cohort than in the control group, which was computed using the Cox proportional model. Age-specific analysis revealed that the adjusted hazard ratios (aHRs) of ESRD for HFr patients increased slightly as age increased, with an aHR of 1.56 (95% CI:1.35-1.81) for patients 65-74 years old, which gradually decreased to 0.88 (95% CI:0.66-1.18) for patients ≥ 85 years old. ESRD risk increased as HFr severity increased, with an aHR of 6.71 (95% CI:5.90-7.63) for patients with severe HFr.
  
  
  CONCLUSIONS
  This study is the first to report that HFr, in combination with underlying osteoporosis-related chronic illness, microvascular disease and chronic inflammation, is associated with an increased risk of ESRD, particularly among relatively younger people.
authors.affiliation: Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Tseng
authors.affiliation: Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Wei-Shih
authors.initials: WS
authors.lastname: Huang
authors.affiliation: Graduate Institute of Biostatistics, College of Management, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan.
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Hsuan-Ju
authors.initials: HJ
authors.lastname: Chen
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology*; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D010024:Osteoporosis / Q000453:epidemiology; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
keywords: Charlson comorbidity index (CCI); End-stage renal disease (ESRD); Hip fracture (HFr); Inflammation