Oral anticoagulant treatment and risk for bone fractures in uremic hemodialysed patients

Vitamin K is involved in bone metabolism, and the clinical use of vitamin K antagonists as an anticoagulant may increase the risk of bone fracture. In our renal unit, approximately 140 uremic patients were hemodialyzed. From these patients, 11 have been under anticoagulant treatment for a long time. For the last 2 years, 5 patients presented with bone fracture, and 4 of them were undergoing oral anticoagulant treatment (acenocoumarol 1 mg daily). The dose was modified according to international normalized ratio (INR) units. The use of vitamin K antagonists as anticoagulants has been considered a cause of bleeding and is related to low bone-mineral density and a high risk of fracture. In our data, the number of patients who received oral anticoagulants (11 patients) and the number of them who presented with bone fracture (4 patients) raises the suspicion that there is an association between anticoagulant treatments and bone fractures.