Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures: A nationwide case-matched cohort study

Chiu Huang Kuo, Tsung Cheng Hsieh, Chih Hsien Wang, Chu Lin Chou, Yu Hsien Lai, Yi Ya Chen, Yu Li Lin, Sheng Teng Wu, Te Chao Fang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. Methods: Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. Results: After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p <0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p <0.001), stroke (HR = 1.19, p <0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p <0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. Conclusions: The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications.

Original languageEnglish
Article numbere0121705
JournalPLoS One
Volume10
Issue number4
DOIs
Publication statusPublished - Apr 13 2015

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bone fractures
hemodialysis
Bone Fractures
cohort studies
Renal Dialysis
Bone
Cohort Studies
Mortality
Arterial Occlusive Diseases
Peripheral Arterial Disease
stroke
Coronary Artery Disease
Stroke
National Institutes of Health
Health
Sex Ratio
National Institutes of Health (U.S.)
Taiwan

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures : A nationwide case-matched cohort study. / Kuo, Chiu Huang; Hsieh, Tsung Cheng; Wang, Chih Hsien; Chou, Chu Lin; Lai, Yu Hsien; Chen, Yi Ya; Lin, Yu Li; Wu, Sheng Teng; Fang, Te Chao.

In: PLoS One, Vol. 10, No. 4, e0121705, 13.04.2015.

Research output: Contribution to journalArticle

Kuo, Chiu Huang ; Hsieh, Tsung Cheng ; Wang, Chih Hsien ; Chou, Chu Lin ; Lai, Yu Hsien ; Chen, Yi Ya ; Lin, Yu Li ; Wu, Sheng Teng ; Fang, Te Chao. / Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures : A nationwide case-matched cohort study. In: PLoS One. 2015 ; Vol. 10, No. 4.
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abstract = "Background: Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. Methods: Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. Results: After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p <0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p <0.001), stroke (HR = 1.19, p <0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p <0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. Conclusions: The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications.",
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T1 - Increased risks of mortality and atherosclerotic complications in incident hemodialysis patients subsequently with bone fractures

T2 - A nationwide case-matched cohort study

AU - Kuo, Chiu Huang

AU - Hsieh, Tsung Cheng

AU - Wang, Chih Hsien

AU - Chou, Chu Lin

AU - Lai, Yu Hsien

AU - Chen, Yi Ya

AU - Lin, Yu Li

AU - Wu, Sheng Teng

AU - Fang, Te Chao

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Y1 - 2015/4/13

N2 - Background: Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. Methods: Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. Results: After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p <0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p <0.001), stroke (HR = 1.19, p <0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p <0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. Conclusions: The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications.

AB - Background: Hemodialysis (HD) patients with bone fractures have an increased risk for death. However, the risks for mortality and atherosclerotic complications in incident HD patients subsequently with bone fractures are unknown. Methods: Data derived from the Taiwan National Health Institute Research Database between January 1997 and December 2008 was analyzed. The enrolled patients included 3,008 incident HD patients subsequently with a single long bone fracture (LB Fx) and 2,070 incident HD patients subsequently with a single non-long bone fracture (NLB Fx). These patients were matched (1:5 ratio) for age, sex, and same duration of HD with incident HD patients who had no fractures and outcomes were measured over a 3-year follow-up. Results: After demographic and co-morbidity adjustment, LB Fx increased the risk for overall mortality (HR = 1.59, p <0.001) and stroke (HR = 1.09, p = 0.028) in incident HD patients. NLB Fx increased the risk for overall mortality (HR = 1.52, p <0.001), stroke (HR = 1.19, p <0.001), coronary artery disease (CAD), (HR = 1.13, p = 0.003), and peripheral arterial occlusive disease (PAOD), (HR = 1.41, p <0.001) in incident HD patients. Moreover, incident patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx. Conclusions: The rates of mortality and stroke were significantly higher in incident HD patients subsequently with bone fractures than in matched patients without bone fractures. Incident HD patients subsequently with NLB Fx had significantly higher risks of CAD and PAOD than those subsequently with LB Fx and without bone fractures. Thus, incident HD patients subsequently with bone fractures should be closely followed for a higher mortality and possible development of atherosclerotic complications.

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