Hemodialysis Product and Hip Fracture in Hemodialysis Patients: A Nationwide Cohort Study in Japan

Ther Apher Dial. 2019 Dec;23(6):507-517. doi: 10.1111/1744-9987.12807. Epub 2019 May 8.


Some have raised concerns that longer and more frequent hemodialysis (HD) would be associated with bone fractures due to excess phosphate removal. We examined the effects of hemodialysis product (HDP) on hip fracture incidence among Japanese HD patients using registry data of the Japanese Society for Dialysis Therapy. During a 1-year study period, 1411 hip fractures occurred among 135 984 patients. After adjusting for demographic and clinical factors, patients with a high HDP did not show a significant risk of hip fracture. Interestingly, patients with polycystic kidney disease had a lower risk of hip fracture. Our findings did not support the hypothesis that patients undergoing longer and more frequent HD would face a higher risk of hip fracture than those undergoing shorter and less frequent HD. Polycystic kidney disease was identified as a new significant factor for hip fracture; relative to glomerulonephritis, this condition was associated with a lower risk of hip fracture.

Keywords: Bone fracture; Fibroblast growth factor 23; Hemodialysis; Hemodialysis product; Phosphatemia; Polycystic kidney disease.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Hip Fractures / epidemiology*
  • Humans
  • Incidence
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Polycystic Kidney Diseases / epidemiology*
  • Polycystic Kidney Diseases / therapy
  • Prospective Studies
  • Renal Dialysis / statistics & numerical data*
  • Risk Factors