Kidney Week

Abstract: TH-PO060

Increased Bone Fracture Risk after Recovery from AKI

Session Information

• AKI: Clinical, Outcomes, and Trials - Epidemiology and Pathophysiology
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• McCune, Thomas R., Eastern Virginia Medical School, Norfolk, Virginia, United States

Thomas R. McCune, MD, FASN

• Ozanne, Marie V., Mount Holyoke College, South Hadley, Massachusetts, United States

Marie V. Ozanne, PhD

• Qiao, Xian, Eastern Virginia Medical School, Norfolk, Virginia, United States

Xian Qiao, MD

• Toepp, Angela J., Eastern Virginia Medical School, Norfolk, Virginia, United States

Angela J. Toepp, MS, PhD

• Kacena, Melissa A., Indiana University Purdue University Indianapolis, Indianapolis, Indiana, United States

Melissa A. Kacena, PhD

Group or Team Name

• EVMS/IU Metabolic Bone Disease Consortium.

Background

Acute kidney injury(AKI) that requires dialysis can be a complication during hospitalization. A population study from Taiwan found that patients recovered from AKI observed an increased risk fractures in weight bearing bones the first year (HR = 6.02, 95% CI 1.43–17.22; p = 0.02). We evaluated the risk of weight bearing fractures after recovery (>6 months) in a similar population data base.

Methods

This is a retrospective cohort study using data (accesed 1/23/24) from TriNetX COVID-19 Research Network, including deidentified EHR of 115+ million individuals in 85 healthcare organizations. Inclusion criteria: inpatient encounter (1/20/20-12/2022). Exclusion criteria: ESRD (N18.6), renal transplant (Z94.0/Z48.22), COVID infection, or neoplasm (C00-D49). Age 18 to 89 years. Propensity score matching (1:1) balanced three covariates between groups. Univariate logistic regression was conducted predicting AKI and weight bearing fractures (>6 months).

Results

Table 1: Study population fracture rates
Figure 1: Risk of fractures by location (ICD-10)

Conclusion

1. AKI increases the risk of weight bearing bone fractures(>6 months) (HR=1.527, 95% CI 1.455-1.603; p=0.01).
2. All weight bearing bone groups are impacted after AKI.
3. Managemant of AKI should address alterations in bone mineral metabolism.

Table 1: Population analysis of fracture free survival AKI vs. NO AKI

Figure 1: Risk of fracture after recovery of AKI (6 months+). ICD-10 codes for fracture locations

Funding

• Private Foundation Support