{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:36:15Z","timestamp":1774611375716,"version":"3.50.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T00:00:00Z","timestamp":1634515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100019124","name":"Asia University Hospital","doi-asserted-by":"crossref","award":["AUH-10651015"],"award-info":[{"award-number":["AUH-10651015"]}],"id":[{"id":"10.13039\/100019124","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hip fracture is a significant health problem and is associated with increased mortality. Patients with chronic kidney disease (CKD) are more at risk of hip fracture than the general population, but the hip fracture risk is not evident among non-dialysis CKD stage 5 patients. This study aims to assess the risk of hip fracture in patients with non-dialysis CKD stage 5 comparing to those with CKD stages 1\u20134. Patients with non-dialysis CKD stage 5 and CKD stages 1\u20134 were retrieved from Taiwan longitudinal health insurance database 2011\u20132014. All patients were followed to the end of 2018 for the development of hip fractures. We analyze the risk of hip fracture of propensity score-matched patients with CKD stage 5 compared to patients with CKD stages 1\u20134 using stepwise Cox regression and competing risks regression. We analyzed 5649 propensity score-matched non-dialysis CKD 1\u20134 patients and non-dialysis CKD 5 patients between 2011 and 2014. All patients were followed to the end of 2018, 229 (4.1%) of CKD 1\u20134 patients in 21,899 patient-year, and 290 (5.1%) of CKD 5 patients had hip fractures in 18,137 patient-year. CKD 5 patients had a higher risk of hip fracture than patients with CKD stages 1\u20134. The adjusted HR was 1.53 (95% CI 1.08\u20131.54) in the Cox regression with adjustments for age, gender, comorbidity, and history of fracture. In the competing risks regression, the subdistribution hazard ratio was 1.29 (95% CI 1.08\u20131.54). Female gender, age, history of fractures, and Charlson\u2013Deyo comorbidity index were independently associated with increased hip fracture risks. Non-dialysis CKD 5 patients had a higher risk of hip fracture than patients with CKD stages 1\u20134. This association is independent of patients\u2019 age, female gender, history of fractures, and comorbidities.<\/jats:p>","DOI":"10.1038\/s41598-021-00157-1","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T19:27:17Z","timestamp":1634585237000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hip fracture in patients with non-dialysis chronic kidney disease stage 5"],"prefix":"10.1038","volume":"11","author":[{"given":"Chao-Hsiun","family":"Tang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Che-Yi","family":"Chou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,18]]},"reference":[{"key":"157_CR1","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1007\/s11657-013-0136-1","volume":"8","author":"E Hernlund","year":"2013","unstructured":"Hernlund, E. et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch. Osteoporos. 8, 136. https:\/\/doi.org\/10.1007\/s11657-013-0136-1 (2013).","journal-title":"Arch. Osteoporos."},{"key":"157_CR2","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12877-016-0332-0","volume":"16","author":"SM Dyer","year":"2016","unstructured":"Dyer, S. M. et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr. 16, 158. https:\/\/doi.org\/10.1186\/s12877-016-0332-0 (2016).","journal-title":"BMC Geriatr."},{"key":"157_CR3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020312","volume":"8","author":"L Robertson","year":"2018","unstructured":"Robertson, L. et al. Hip fracture incidence and mortality in chronic kidney disease: The GLOMMS-II record linkage cohort study. BMJ Open 8, e020312. https:\/\/doi.org\/10.1136\/bmjopen-2017-020312 (2018).","journal-title":"BMJ Open"},{"key":"157_CR4","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.arth.2019.09.016","volume":"35","author":"SJ Lin","year":"2020","unstructured":"Lin, S. J. et al. Effects of chronic kidney disease on hemiarthroplasty outcomes for fragility hip fracture in diabetic patients: A Nationwide Population-Based Observational Study. J. Arthroplast. 35, 477-484.e474. https:\/\/doi.org\/10.1016\/j.arth.2019.09.016 (2020).","journal-title":"J. Arthroplast."},{"key":"157_CR5","doi-asserted-by":"publisher","first-page":"E299","DOI":"10.1503\/cmaj.181186","volume":"191","author":"L Azzalini","year":"2019","unstructured":"Azzalini, L. et al. A disease-specific comorbidity index for predicting mortality in patients admitted to hospital with a cardiac condition. CMAJ 191, E299\u2013E307. https:\/\/doi.org\/10.1503\/cmaj.181186 (2019).","journal-title":"CMAJ"},{"key":"157_CR6","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.cmpb.2016.10.003","volume":"138","author":"W Wang","year":"2017","unstructured":"Wang, W., Wang, W., Mosley, T. H. & Griswold, M. E. A SAS macro for the joint modeling of longitudinal outcomes and multiple competing risk dropouts. Comput. Methods Programs Biomed. 138, 23\u201330. https:\/\/doi.org\/10.1016\/j.cmpb.2016.10.003 (2017).","journal-title":"Comput. Methods Programs Biomed."},{"key":"157_CR7","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1038\/ki.2013.547","volume":"86","author":"KL Naylor","year":"2014","unstructured":"Naylor, K. L. et al. The three-year incidence of fracture in chronic kidney disease. Kidney Int. 86, 810\u2013818. https:\/\/doi.org\/10.1038\/ki.2013.547 (2014).","journal-title":"Kidney Int."},{"key":"157_CR8","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1016\/j.bone.2014.12.020","volume":"73","author":"MJ Perez-Saez","year":"2015","unstructured":"Perez-Saez, M. J. et al. Increased hip fracture and mortality in chronic kidney disease individuals: The importance of competing risks. Bone 73, 154\u2013159. https:\/\/doi.org\/10.1016\/j.bone.2014.12.020 (2015).","journal-title":"Bone"},{"key":"157_CR9","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1016\/j.kint.2017.07.021","volume":"92","author":"A Pimentel","year":"2017","unstructured":"Pimentel, A., Urena-Torres, P., Zillikens, M. C., Bover, J. & Cohen-Solal, M. Fractures in patients with CKD-diagnosis, treatment, and prevention: A review by members of the European Calcified Tissue Society and the European Renal Association of Nephrology Dialysis and Transplantation. Kidney Int. 92, 1343\u20131355. https:\/\/doi.org\/10.1016\/j.kint.2017.07.021 (2017).","journal-title":"Kidney Int."},{"key":"157_CR10","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.kisu.2017.10.001","volume":"7","author":"Erratum: Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group","year":"2017","unstructured":"Erratum: Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group. KDIGO 2017 Clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int. Suppl. 2017;7:1\u201359. Kidney Int. Suppl. 7, e1. https:\/\/doi.org\/10.1016\/j.kisu.2017.10.001 (2017).","journal-title":"Kidney Int. Suppl."},{"key":"157_CR11","doi-asserted-by":"publisher","first-page":"665","DOI":"10.2215\/CJN.12401019","volume":"15","author":"JQ Ho","year":"2020","unstructured":"Ho, J. Q., Verghese, J. & Abramowitz, M. K. 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