{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:19:00Z","timestamp":1778815140908,"version":"3.51.4"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T00:00:00Z","timestamp":1579219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previous studies evaluating fractures in chronic kidney disease (CKD) have mostly focused on hip or major fractures in aged populations with moderate to advanced CKD. We aimed at evaluating the association between early CKD and fracture incidence at all sites across age and sex in middle-aged individuals.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed CARTaGENE, a prospective population-based survey of 40- to 69-year-old individuals from Quebec (Canada). Estimated glomerular filtration rate (eGFR) at baseline was evaluated categorically or continuously using restricted cubic splines. Fractures at any site (except toes, hand and craniofacial) for up to 7\u2009years of follow-up were identified through administrative databases using a validated algorithm. Adjusted Cox models were used to evaluate the association of CKD with fracture. Interaction terms for age and sex were also added.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 19\u2009391 individuals (756 CKD Stage 3; 9114 Stage 2; 9521 non-CKD) were included and 829 fractures occurred during a median follow-up of 70\u2009months. Compared with the median eGFR of 90\u2009mL\/min\/1.73\u2009m2, eGFRs of \u226460\u2009mL\/min\/1.73\u2009m2 were associated with increased fracture incidence in unadjusted and adjusted models [adjusted hazard ratio (HR)\u2009=\u20091.25 (95% confidence interval 1.05\u20131.49) for 60\u2009mL\/min\/1.73\u2009m2; 1.65 (1.14\u20132.37) for 45\u2009mL\/min\/1.73\u2009m2]. The eGFR was linearly associated with fracture incidence &amp;lt;75\u2009mL\/min\/1.73\u2009m2 [HR\u2009=\u20091.18 (1.04\u20131.34) per 10\u2009mL\/min\/1.73\u2009m2 decrease] but not above [HR\u2009=\u20090.98 (0.91\u20131.06) per 10\u2009mL\/min\/1.73\u2009m2 decrease). The effect of decreased eGFR on fracture incidence was more pronounced in younger individuals [HR\u2009=\u20092.45 (1.28\u20134.67) at 45\u2009years; 1.11 (0.73\u20131.67) at 65\u2009years] and in men.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Even early CKD increases fracture incidence, especially in younger individuals and in men.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ndt\/gfz259","type":"journal-article","created":{"date-parts":[[2019,11,15]],"date-time":"2019-11-15T12:10:35Z","timestamp":1573819835000},"page":"1712-1721","source":"Crossref","is-referenced-by-count":19,"title":["Incidence of fractures in middle-aged individuals with early chronic kidney disease: a population-based analysis of CARTaGENE"],"prefix":"10.1093","volume":"35","author":[{"given":"Louis-Charles","family":"Desbiens","sequence":"first","affiliation":[{"name":"Faculty and Department of Medicine, Endocrinology and Nephrology Axis, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Quebec City, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R\u00e9mi","family":"Goupil","sequence":"additional","affiliation":[{"name":"H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Faculty and Department of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7ois","family":"Madore","sequence":"additional","affiliation":[{"name":"H\u00f4pital du Sacr\u00e9-Coeur de Montr\u00e9al, Faculty and Department of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6879-9344","authenticated-orcid":false,"given":"Fabrice","family":"Mac-Way","sequence":"additional","affiliation":[{"name":"Faculty and Department of Medicine, Endocrinology and Nephrology Axis, CHU de Qu\u00e9bec-Universit\u00e9 Laval, Quebec City, QC, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2020,1,17]]},"reference":[{"key":"2020100618542741300_gfz259-B1","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/hy1001.096358","article-title":"Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease","volume":"38","author":"Blacher","year":"2001","journal-title":"Hypertension"},{"key":"2020100618542741300_gfz259-B2","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.kint.2015.12.004","article-title":"Changing bone patterns with progression of chronic kidney disease","volume":"89","author":"Drueke","year":"2016","journal-title":"Kidney Int"},{"key":"2020100618542741300_gfz259-B3","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","article-title":"Definition, evaluation, and classification of renal osteodystrophy: a position 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