{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T20:48:47Z","timestamp":1786135727398,"version":"build-2736575974"},"reference-count":58,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R21DK116151"],"award-info":[{"award-number":["R21DK116151"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P50DK114786"],"award-info":[{"award-number":["P50DK114786"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["CRN-2020-007"],"award-info":[{"award-number":["CRN-2020-007"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["JASN"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Children with glomerular disease have unique risk factors for compromised bone health. Studies addressing skeletal complications in this population are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study utilized data from PEDSnet, a national network of pediatric health systems with standardized electronic health record data for more than 6.5 million patients from 2009 to 2021. Incidence rates (per 10,000 person-years) of fracture, slipped capital femoral epiphysis (SCFE), and avascular necrosis\/osteonecrosis (AVN) in 4598 children and young adults with glomerular disease were compared with those among 553,624 general pediatric patients using Poisson regression analysis. The glomerular disease cohort was identified using a published computable phenotype. Inclusion criteria for the general pediatric cohort were two or more primary care visits 1 year or more apart between 1 and 21 years of age, one visit or more every 18 months if followed &gt;3 years, and no chronic progressive conditions defined by the Pediatric Medical Complexity Algorithm. Fracture, SCFE, and AVN were identified using SNOMED-CT diagnosis codes; fracture required an associated x-ray or splinting\/casting procedure within 48 hours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found a higher risk of fracture for the glomerular disease cohort compared with the general pediatric cohort in girls only (incidence rate ratio [IRR], 1.6; 95% CI, 1.3 to 1.9). Hip\/femur and vertebral fracture risk were increased in the glomerular disease cohort: adjusted IRR was 2.2 (95% CI, 1.3 to 3.7) and 5 (95% CI, 3.2 to 7.6), respectively. For SCFE, the adjusted IRR was 3.4 (95% CI, 1.9 to 5.9). For AVN, the adjusted IRR was 56.2 (95% CI, 40.7 to 77.5).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children and young adults with glomerular disease have significantly higher burden of skeletal complications than the general pediatric population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.2021101372","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T12:10:17Z","timestamp":1664367017000},"page":"2233-2246","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Skeletal Outcomes in Children and Young Adults with Glomerular Disease"],"prefix":"10.1681","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2942-4654","authenticated-orcid":false,"given":"Amy J.","family":"Goodwin Davies","sequence":"first","affiliation":[{"name":"Division of General Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanieh","family":"Razzaghi","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Charles","family":"Bailey","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"Department of Biomedical and Health Informatics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Levon","family":"Utidjian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Gluck","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Nemours\/Alfred I. DuPont Hospital for Children, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0977-3275","authenticated-orcid":false,"given":"Daniel","family":"Eckrich","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Nemours\/Alfred I. DuPont Hospital for Children, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3704-0922","authenticated-orcid":false,"given":"Bradley P.","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado"},{"name":"Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara J.","family":"Deakyne Davies","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7232-7975","authenticated-orcid":false,"given":"Joseph T.","family":"Flynn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Washington, Seattle, Washington"},{"name":"Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daksha","family":"Ranade","sequence":"additional","affiliation":[{"name":"Seattle Children\u2019s Hospital, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1982-9938","authenticated-orcid":false,"given":"William E.","family":"Smoyer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Ohio State University, Columbus, Ohio"},{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melody","family":"Kitzmiller","sequence":"additional","affiliation":[{"name":"Nationwide Children\u2019s Hospital, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas R.","family":"Dharnidharka","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri"},{"name":"St. Louis Children\u2019s Hospital, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brianna","family":"Magnusen","sequence":"additional","affiliation":[{"name":"St. Louis Children\u2019s Hospital, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-0250","authenticated-orcid":false,"given":"Mark","family":"Mitsnefes","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Somers","sequence":"additional","affiliation":[{"name":"Boston Children\u2019s Hospital, Harvard University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna J.","family":"Claes","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-9613","authenticated-orcid":false,"given":"Evanette K.","family":"Burrows","sequence":"additional","affiliation":[{"name":"Division of General Pediatrics, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid Y.","family":"Luna","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Furth","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"},{"name":"Department of Pediatrics, Perelman School of Medicine at the University 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