title: Hip Fracture in Patients With Non-Dialysis-Requiring Chronic Kidney Disease.
abstract: Patients with end-stage renal disease (ESRD) are at a high risk for hip fracture. Little is known about the risk for, and consequences of, hip fracture among patients with non-dialysis-requiring chronic kidney disease (CKD). We examined the incidence of hip fracture, in-hospital mortality, length of stay, and costs among patients with ESRD, non-dialysis-requiring CKD, and normal or near normal kidney function. Using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, a nationally representative database, we identified hospitalizations for hip fracture in 2010. We incorporated data from the United States Renal Data System (USRDS) and the US census to calculate population-specific rates. Age-standardized incidence of hip fracture was highest among patients with ESRD (3.89/1000 person-years), followed by non-dialysis-requiring CKD (1.81/1000 persons) and patients with normal or near normal kidney function (1.18/1000 persons). In-hospital mo rtality (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.46 to 1.96), lengths of stay (median [10th, 90th percentiles] 5 [3 to 11] versus 5 [3 to 10] days) and costs (median $14,807 versus $13,314) were significantly higher in patients with non-dialysis-requiring CKD relative to patients with normal or near normal kidney function. In summary, non-dialysis-requiring CKD is associated with higher age-standardized rates of hip fracture and post-hip fracture mortality and higher resource utilization. © 2016 American Society for Bone and Mineral Research.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Sun Moon
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Jin
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Montez-Rath
authors.affiliation: Departments of Medicine and Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Leonard
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. gchertow@stanford.edu.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
mesh_terms: D000328:Adult; D000368:Aged; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006620:Hip Fractures / Q000191:economics / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000191:economics / Q000401:mortality* / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012307:Risk Factors; D015996:Survival Rate
keywords: HIP FRACTURES; KIDNEY FAILURE; NATIONWIDE INPATIENT SAMPLE; RENAL INSUFFICIENCY