1.Associated factors of osteoporosis and the impact of osteoporosis on all-cause mortality in incident hemodialysis older patients
Seunghye LEE ; Yoomee KANG ; Yu Ah HONG ; Sung Joon SHIN ; Soon Hyo KWON ; Sungjin CHUNG ; Young Youl HYUN ; Sang Heon SONG ; Jae Won YANG ; Won Min HWANG ; Jang-Hee CHO ; Kyung Don YOO ; In O SUN ; Gang-Jee KO ; Byung Chul YU ; Hyunsuk KIM ; Woo Yeong PARK ; Tae Won LEE ; Dong Jun PARK ; Eunjin BAE ;
Kidney Research and Clinical Practice 2026;45(1):110-119
Background:
With the aging population and advancements in medical care worldwide, the number of older patients with end-stage kidney disease continues to rise. This study aimed to identify factors associated with osteoporosis and osteopenia in older patients undergoing incident hemodialysis and assess their impact on mortality.
Methods:
We analyzed a large multicenter retrospective cohort of patients aged ≥70 years undergoing incident hemodialysis to identify factors associated with osteoporosis using logistic regression analysis and to assess the association of death with osteoporosis and osteopenia using Cox multivariable analysis.
Results:
Among 710 patients, 39.0% and 19.6% had osteoporosis and osteopenia, respectively. Osteoporosis was significantly associated with female sex, a history of fractures, and the absence of phosphate binder use. During a median follow-up of 36.8 months, 348 participants (58.8%) died. Mortality rates were the highest in the osteoporosis group (79.8%), followed by the osteopenia (77.2%) and normal bone mineral density (BMD) groups (35.2%). Cox regression analysis revealed that even after adjusting for covariates, the osteoporosis group was significantly associated with a higher mortality risk than the normal BMD group. Osteoporosis at the start of hemodialysis was significantly associated with higher mortality.
Conclusion
We should consider the importance of bone health in patients undergoing incident hemodialysis and pay attention to the use of phosphate binders and fracture prevention.
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