ORIGINAL ARTICLEUse of Renal Function Measurements for Assessing Fracture Risk in Postmenopausal Women
Section snippets
PARTICIPANTS AND METHODS
After approval by the Mayo Clinic Institutional Review Board, participants were recruited from age-stratified random samples of residents of Rochester, MN. Two previously described cohorts were combined for this analysis. Cohort A was recruited from a random sample of Rochester women attended at Mayo Clinic in 1979-1981 who were enrolled between January 4, 1980, and March 25, 1984; women in cohort B were enrolled between September 16, 1991, and April 23, 1993, from among Rochester women sampled
RESULTS
To enroll about 50 women per decade of age in cohort A, 541 women aged 30 years or older were sampled.32 Thirty-eight (7%) of these women were deemed to be ineligible for study, mainly because of dementia. Of the 503 women eligible for cohort A, 304 (60%) agreed to participate.32 Following the same procedure, of 812 eligible women in cohort B, 351 (43%) agreed to participate.33
Of these 655 women, only the 438 (67%) who were postmenopausal (225 in cohort A, 213 in cohort B) were considered for
DISCUSSION
Although BMD measurements by DEXA provide the basis for diagnosing osteoporosis,17 this approach has substantial limitations with respect to assessing future fracture risk.49 Therefore, the World Health Organization has introduced its fracture risk assessment (FRAX) algorithm, which combines femoral neck BMD measurements with clinical risk factors, including age, sex, body mass index, parental history of fracture, personal history of fracture, rheumatoid arthritis or other risk factors for
CONCLUSION
Despite potential limitations, our study data are the only data available on the use of measurements of renal function and eGFR to predict long-term risk of fractures. More importantly, if increases in hip fractures with reduced renal function are caused by bone loss, rather than fall-related factors, one would expect to see an increase in fractures of all types. Instead, we saw no such increase in fractures generally, in moderate trauma fractures, in osteoporotic fractures, or in hip fractures
Acknowledgments
The authors thank Barbara Nolte, RN, for her assistance with data collection, and Mary Roberts for her help in preparing the submitted manuscript.
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This study was supported by research grants from the National Institutes of Health, US Public Health Service (R01 AR27065, PO1 AG04875, R01 AR30582, and M01 RR00585).