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12-09-2010 | Bone health | Article

New study will assess fracture risk in chronic kidney disease


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MedWire News: Researchers in Canada have initiated a 2-year study that aims to identify prognostic factors for bone loss and fractures in patients with stage 3 to 5 chronic kidney disease (CKD).

"CKD affects 5-10% of the world population and is associated with many adverse outcomes including bone disorders and fractures," explain Sarah West (University of Toronto, Ontario), and colleagues.

"Decreased bone mass and disruption of microarchitecture occur early in the course of CKD and worsen with the progressive decline in renal function, so that at the time of initiation of dialysis, at least 50% of patients have had a fracture," they add.

To expand the current knowledge of prognostic factors for fracture in end-stage renal disease (ESRD) to the CKD stage 3 to 5 population, West and team set up the FRACTURE (Fracture Risk Assessment in Chronic Kidney Disease, Prospective Testing Under Real World Environments) study.

The prospective study aims to enroll 260 men and women aged 18 years and older, with stage 3 to 5 CKD, defined as a glomerular filtration rate at or below 60 ml/min/1.73 m2 at study entry (baseline).

At baseline, 12, and 24 months, the researchers will measure participants' bone mineral density by dual-energy X-ray absorptiometry at the spine, hip, and radius, their volumetric bone density, using high-resolution peripheral quantitative computed tomography at the radius and tibia, serum markers of bone turnover, and muscle strength and balance. Bone formation rate will be measured by bone biopsy at the 12-month assessment only.

The team will then examine the ability of each of these variables to predict spine and non-spine fractures, identified by self-report and/or vertebral morphometry.

"This study is one of the first that aims to identify risk factors for fracture in early stage CKD patients," remark West and co-authors in the open access journal BMC Nephrology.

"Ultimately, by identifying risk factors for fracture and targeting treatments in this group-before the initiation of renal replacement therapy - we will reduce the burden of disease due to fractures among patients with CKD," they conclude.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Laura Dean

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