||Background: The burden of End Stage Renal Disease (ESRD) is a growing concern worldwide. According to the United States Renal Data System for 2010, the prevalence and incidence of hemodialysis in Taiwan is the highest in the world. Hemodialysis patients commonly have complications, including osteoporotic fracture-associated diseases, which affect the quality of life.|
Objective: This study aimed to explore the incidences of various osteoporotic fractures and related risk factors.
Methods: A nationwide prospective study based on the Taiwan National Health Insurance database was conducted during 2001–2007. The study analyzed the incidence of osteoporotic fractures and medical resource utilization in ESRD patients. The International Classification of Diseases (ICD) 9-CM diagnosis codes and treatment codes were identified as the inclusion criteria for osteoporotic fractures. Data were statistically analyzed by means of descriptive analysis, independent t-test, Chi-square test, and logistic regression.
Results: A total of 4016 Taiwanese people with ESRD in hemodialysis were identified in 2001, and 729 injuries occurred during the 6-year follow-up period. The cumulative incidences of lower limb fractures, upper limb fractures, and vertebral fractures were 6.94%, 5.60%, and 4.75%, respectively. Hemodialysis patients with and without osteoporotic fractures were significantly different by sex and geographic region. A higher incidence of fractures was observed in females than in males.
Conclusions: In conclusion, the information regarding clinical symptoms was not available from our database because the National Health Insurance database has ICD 9-CM diagnosis codes only. This study also confirms the strong influence of dialysis treatment on all types of orthopedic injuries and osteoporotic fractures. We hope to present the risk factors as an important point through which to notify hemodialysis patients to prevent orthopedic injuries and osteoporotic fractures, so that these patients will regularly bone density measurements. Therefore, policy makers should take the prevention of osteoporotic fractures in ESRD patients into consideration.