{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:58:41Z","timestamp":1790423921633,"version":"4.1.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2016,6]]},"abstract":"\n Background and objectives<\/jats:title>\n Patients on hemodialysis have a high rate of hip fractures. In this study, we performed a contemporary analysis of mineral and bone parameters and their relationship to hip and femur fracture risk.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n Patients on hemodialysis treated between 2000 and 2013 in Fresenius Medical Care North America facilities were included. Predictors were on the basis of data as of December 31 of each baseline year and time-averaged values of selected laboratory parameters and medication doses throughout the year. Four period cohorts were constructed from baseline years: 2000, 2003, 2006, and 2009. Follow-up for each cohort was \u22643 years.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The incidence of hip and femur fractures remained generally unchanged (\n P<\/jats:italic>\n =0.40), except among patients who were white and >65 years of age, in whom the rate decreased significantly over the 14-year period (\n P<\/jats:italic>\n <0.01). Results from combined multivariable models indicated that the lowest quartiles of time\u2013averaged intact parathyroid hormone were independently associated with higher hip fracture risk (intact parathyroid hormone =181\u2013272 pg\/ml: hazard ratio, 1.20; 95% confidence interval [95% CI], 1.03 to 1.41 and intact parathyroid hormone <181 pg\/ml: hazard ratio, 1.20; 95% CI, 1.01 to 1.44; referent third quartile, 273 to <433 pg\/ml). The lowest quartile of time\u2013averaged serum calcium was also associated with higher risk (calcium <8.7 mg\/dl; hazard ratio, 1.17; 95% CI, 1.00 to 1.37) compared with the referent third quartile of 9.1 to <9.5 mg\/dl.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n We found an association between lower levels of intact parathyroid hormone and serum calcium and greater risk for hip and femur fractures among patients on hemodialysis. These findings support additional research toward elucidating long-term safety of treatment approaches for hyperparathyroidism in patients with ESRD.<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.09280915","type":"journal-article","created":{"date-parts":[[2016,3,29]],"date-time":"2016-03-29T23:00:18Z","timestamp":1459292418000},"page":"1063-1072","source":"Crossref","is-referenced-by-count":32,"title":["Bone Parameters and Risk of Hip and Femur Fractures in Patients on Hemodialysis"],"prefix":"10.2215","volume":"11","author":[{"given":"Steven","family":"Fishbane","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Hofstra North Shore\u2013Long Island Jewish School of Medicine, Great Neck, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azzour D.","family":"Hazzan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Hofstra North Shore\u2013Long Island Jewish School of Medicine, Great Neck, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenar D.","family":"Jhaveri","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Hofstra North Shore\u2013Long Island Jewish School of Medicine, Great Neck, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Ma","sequence":"additional","affiliation":[{"name":"Fresenius Medical Care North America, Waltham, Massachusetts; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Lacson","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2016,3,29]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1046\/j.1523-1755.2000.00178.x","article-title":"Increased risk of hip fracture among patients with end-stage renal disease.","volume":"58","author":"Alem","year":"2000","journal-title":"Kidney Int"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.2215\/CJN.10901012","article-title":"Temporal trends in the incidence, treatment, and outcomes of hip fracture in older patients initiating dialysis in the United States.","volume":"8","author":"Nair","year":"2013","journal-title":"Clin J Am Soc Nephrol"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1681\/ASN.2012090916","article-title":"Temporal trends in fracture rates and postdischarge outcomes among hemodialysis patients.","volume":"24","author":"Beaubrun","year":"2013","journal-title":"J Am Soc Nephrol"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1093\/ageing\/afq044","article-title":"Declining hip fracture rates in the United States.","volume":"39","author":"Stevens","year":"2010","journal-title":"Age Ageing"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1002\/jbmr.1684","article-title":"Recent trends in hip fracture rates by race\/ethnicity among older US adults.","volume":"27","author":"Wright","year":"2012","journal-title":"J Bone Miner Res"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1093\/ndt\/gft352","article-title":"Increased bone fractures among elderly United States hemodialysis patients.","volume":"29","author":"Wagner","year":"2014","journal-title":"Nephrol Dial 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