Moderate Chronic Kidney Disease in Women Is Associated with Fracture Occurrence Independently of Osteoporosis

Background: Chronic kidney disease (CKD) is associated with increased risk of fragility fracture but whether this is independent of osteoporosis is unclear. Methods: We conducted a retrospective cross-sectional study of 1,702 female patients referred for dual-energy X-ray absorptiometry (DXA) scanning (Lunar IDXA) between September 2006 and April 2007. Estimated glomerular filtration rate (eGFR; ml/min/1.73 m2) by Modification of Diet in Renal Disease was calculated within 1 year (median interval 4 weeks) of the DXA scan. The independent association of self-reported fracture occurrence with eGFR category was assessed using multivariate logistic regression. Results: Mean age (SD) was 61.7 (10.8) years; mean eGFR (SD) was 68.8 (12.2). The percentages of subjects with an eGFR of 75–89, 60–74, 30–59 and 2 test). The adjusted odds ratios (95% confidence interval) of any prior fracture for eGFR 75–89, 60–74 and 30–59 were 1.0 (reference), 1.2 (0.9–1.6) and 1.4 (1.0–1.9), respectively, adjusting simultaneously for age, T score, risk factors and treatment for osteoporosis. Conclusion: Moderate CKD is a significant independent predictor of fracture occurrence.