The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis

The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis

Patients with chronic kidney disease (CKD) are more likely to experience falls and fractures due to renal osteodystrophy and the high prevalence of risk factors for falls. However, it is not well established how great the risk is for falls and fractures for the different stages of CKD compared to th...

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Bibliographic Details
Published in:Osteoporosis international Vol. 31; no. 1; pp. 13 - 29
Main Authors: Goto, N. A., Weststrate, A. C. G., Oosterlaan, F. M., Verhaar, M. C., Willems, H. C., Emmelot-Vonk, M. H., Hamaker, M. E.
Format: Journal Article
Language:English
Published: London Springer London 01-01-2020
Springer Nature B.V
Subjects:
Accidental Falls - statistics & numerical data
Adult
Aged
Case-Control Studies
Cohort Studies
Cross-Sectional Studies
Dialysis
Endocrinology
Falls
Female
Femur
Fractures
Fractures, Bone - complications
Fractures, Bone - epidemiology
Hip
Humans
Kidney diseases
Male
Medicare
Medicine
Medicine & Public Health
Meta-analysis
Nutrition Surveys
Orthopedics
Osteodystrophy
Pelvis
Prospective Studies
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - epidemiology
Renal osteodystrophy
Retrospective Studies
Review
Rheumatology
Risk assessment
Risk factors
Systematic review
United States
Vertebrae
United States
Chronic kidney disease
Dialysis
Fracture
Accidental falls
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Summary:Patients with chronic kidney disease (CKD) are more likely to experience falls and fractures due to renal osteodystrophy and the high prevalence of risk factors for falls. However, it is not well established how great the risk is for falls and fractures for the different stages of CKD compared to the general population. The objective of this systematic review and meta-analysis was to assess whether, and in which degree, CKD was associated with falls and fractures in adults. A systematic search in PubMed, Embase, CINAHL, and The Cochrane Library was performed on 7 September 2018. All retrospective, cross-sectional, and longitudinal studies of adults (18 years of older) that studied the association between CKD, fractures, and falls were included. Additional studies were identified by cross-referencing. A total of 39 publications were included, of which two publications assessed three types of outcome and four publications assessed two types of outcome. Ten studies focused on accidental falling; seventeen studies focused on hip, femur, and pelvis fractures; seven studies focused on vertebral fractures; and thirteen studies focused on any type of fracture without further specification. Generally, the risk of fractures increased when kidney function worsened, with the highest risks in the patients with stage 5 CKD or dialysis. This effect was most pronounced for hip fractures and any type of fractures. Furthermore, results on the association between CKD and accidental falling were contradictory. Compared to the general population, fractures are highly prevalent in patients with CKD. Besides more awareness of timely fracture risk assessment, there also should be more focus on fall prevention.
Bibliography:ObjectType-Article-2
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ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-019-05190-5