Optimising bone health among older people with hip fractures and co-existing advanced chronic kidney disease.
Eur Geriatr Med. 2020 Jun 01;: Authors: Ong T, Yong BKA, Shouter T, Shahrokhi N, Sahota O
PURPOSE: Patients with a hip fracture and co-existing advanced chronic kidney disease (CKD) are at risk of further fractures due to either CKD-mineral bone disease or osteoporosis. METHODS: An analysis of a hospital's hip fracture service registry of patients ≥ 60 years with CKD stage 4 (15-29 ml/min/1.73m2) or stage 5 (< 15 ml/min/1.73m2) over 2 years. RESULTS: 46 patients were included in the analysis. The prevalence of CKD stage 4 and 5 was 3%. The mean age was 84 years, half had ≥ 2 comorbid conditions and 76% had a Nottingham Hip Fracture Score of ≥ 5. 54% and 80% died at 12 months and 2 years. None were on any osteoporosis treatment on discharge. 85% were prescribed either calcium-vitamin D or vitamin D supplementation. 30% had a bone health clinic appointment made, but less than half attended. CONCLUSION: Patients with advanced CKD admitted to hospital with a hip fracture have a poor survival. In many, the focus of care should be on supporting quality daily living and not bone health optimisation. PMID: 32488688 [PubMed - as supplied by publisher]