Hip Fracture in Patients With Non-Dialysis-Requiring Chronic Kidney Disease

J Bone Miner Res. 2016 Oct;31(10):1803-1809. doi: 10.1002/jbmr.2862. Epub 2016 Jul 11.


Patients with end-stage renal disease (ESRD) are at a high risk for hip fracture. Little is known about the risk for, and consequences of, hip fracture among patients with non-dialysis-requiring chronic kidney disease (CKD). We examined the incidence of hip fracture, in-hospital mortality, length of stay, and costs among patients with ESRD, non-dialysis-requiring CKD, and normal or near normal kidney function. Using the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, a nationally representative database, we identified hospitalizations for hip fracture in 2010. We incorporated data from the United States Renal Data System (USRDS) and the US census to calculate population-specific rates. Age-standardized incidence of hip fracture was highest among patients with ESRD (3.89/1000 person-years), followed by non-dialysis-requiring CKD (1.81/1000 persons) and patients with normal or near normal kidney function (1.18/1000 persons). In-hospital mo rtality (odds ratio [OR] = 1.69, 95% confidence interval [CI] 1.46 to 1.96), lengths of stay (median [10th, 90th percentiles] 5 [3 to 11] versus 5 [3 to 10] days) and costs (median $14,807 versus $13,314) were significantly higher in patients with non-dialysis-requiring CKD relative to patients with normal or near normal kidney function. In summary, non-dialysis-requiring CKD is associated with higher age-standardized rates of hip fracture and post-hip fracture mortality and higher resource utilization. © 2016 American Society for Bone and Mineral Research.


Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Costs and Cost Analysis
  • Databases, Factual*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Hip Fractures / economics
  • Hip Fractures / etiology
  • Hip Fractures / mortality*
  • Hip Fractures / therapy
  • Hospital Mortality*
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / economics
  • Kidney Failure, Chronic / mortality*
  • Kidney Failure, Chronic / therapy
  • Length of Stay
  • Male
  • Middle Aged
  • Renal Dialysis
  • Risk Factors
  • Survival Rate