Higher Risk of Hip Fracture Among Patients on Hemodialysis Than on Peritoneal Dialysis: Taiwan National Cohort Study

Hip fractures occur more frequently in patients with chronic kidney disease (CKD) than in the general population [1], and they are an important complication associated with a high mortality rate, decreased quality of life, and large economic burden [2]. The mechanisms of impaired skeletal strength in patients with ESRD are either osteoporosis or renal bone disease, such as adynamic bone disease [2-4]. Old age, female gender, white race, diabetes, and duration of dialysis are also risk factors for hip fractures in patients with CKD5,6. However, few studies have investigated whether different dialysis modalities are risk factors for hip fractures. In addition, few studies have evaluated long-term mortality rates after hip fractures in patients with end-stage renal disease (ESRD) and on dialysis. We recently evaluated the the incidence and outcome of hip fractures in 51, 473 patients with ESRD who began dialysis between 1999 and 2005 [7]. The data source was the Taiwan National Health Insurance Research Database, and the patients were followed until death, transplantation, dialysis cessation, or 31 December 2008.