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Meta-Analysis
. 2020 Jan;31(1):13-29.
doi: 10.1007/s00198-019-05190-5. Epub 2019 Nov 12.

The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis

N A Goto  1   2 , A C G Weststrate  3 , F M Oosterlaan  4 , M C Verhaar  5 , H C Willems  6 , M H Emmelot-Vonk  4 , M E Hamaker  7
Affiliations
Meta-Analysis

The association between chronic kidney disease, falls, and fractures: a systematic review and meta-analysis

N A Goto et al. Osteoporos Int. 2020 Jan.

Abstract

Patients with chronic kidney disease (CKD) are more likely to experience falls and fractures due to renal osteodystrophy and the high prevalence of risk factors for falls. However, it is not well established how great the risk is for falls and fractures for the different stages of CKD compared to the general population. The objective of this systematic review and meta-analysis was to assess whether, and in which degree, CKD was associated with falls and fractures in adults. A systematic search in PubMed, Embase, CINAHL, and The Cochrane Library was performed on 7 September 2018. All retrospective, cross-sectional, and longitudinal studies of adults (18 years of older) that studied the association between CKD, fractures, and falls were included. Additional studies were identified by cross-referencing. A total of 39 publications were included, of which two publications assessed three types of outcome and four publications assessed two types of outcome. Ten studies focused on accidental falling; seventeen studies focused on hip, femur, and pelvis fractures; seven studies focused on vertebral fractures; and thirteen studies focused on any type of fracture without further specification. Generally, the risk of fractures increased when kidney function worsened, with the highest risks in the patients with stage 5 CKD or dialysis. This effect was most pronounced for hip fractures and any type of fractures. Furthermore, results on the association between CKD and accidental falling were contradictory. Compared to the general population, fractures are highly prevalent in patients with CKD. Besides more awareness of timely fracture risk assessment, there also should be more focus on fall prevention.

Keywords: Accidental falls; Chronic kidney disease; Dialysis; Fracture.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Flowchart diagram
Fig. 2
Fig. 2
Quality assessment
Fig. 3
Fig. 3
a–d Association between chronic kidney disease, accidental falls (a), hip fractures (b), vertebral fractures (c), and all fractures (d)
Fig. 4
Fig. 4
a Associations of chronic kidney disease with incidence of hip fractures. b Associations of chronic kidney disease with any type of fracture
Fig. 4
Fig. 4
a Associations of chronic kidney disease with incidence of hip fractures. b Associations of chronic kidney disease with any type of fracture
See this image and copyright information in PMC

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