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In elderly men and women treated for osteoporosis a low creatinine clearance of <65ml/min is a risk factor for falls and fractures

Dukas, Laurent ; Schacht, Erich ; Stähelin, Hannes

In: Osteoporosis International, 2005, vol. 16, no. 12, p. 1683-1690

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    Titre
    • In elderly men and women treated for osteoporosis a low creatinine clearance of <65ml/min is a risk factor for falls and fractures
    Auteur
    • Dukas, Laurent. Geriatric University Clinic, Kantonsspital, Basel, Switzerland
    • Schacht, Erich. Department of Rheumatology and Rehabilitation, University Clinic Balgrist, Zurich, Switzerland
    • Stähelin, Hannes. Geriatric University Clinic, Kantonsspital, Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Osteoporosis International, 2005, vol. 16, no. 12, p. 1683-1690. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:318864
    Summary
    Recently, a low creatinine clearance (CrCl) of <65ml/min was described as a new significant and independent risk factor for the number of fallers and falls in a community-dwelling elderly population. In this study we investigated if a low creatinine clearance of <65ml/min is also a risk factor for falls and fractures in elderly men and women treated for osteoporosis. In a cross-sectional study with the help of questionnaires we assessed the prevalence of having experienced falls within the last 12months according to renal function in 5,313 German men and women receiving treatment for osteoporosis. The CrCl was calculated using the established Cockcroft-Gault formula. The prevalence of falls and fractures was assessed in multivariate-controlled logistic regression models according to a CrCl cut off of 65ml/min. The P -values were two-sided. In this study of elderly men and women treated for osteoporosis ( n =5,313), 60.9% ( n =3,238) had a CrCl of <65ml/min, which was associated in multivariate controlled analyses, compared to a CrCl of ≥65ml/min ( n =2,075), with a significant increased risk of experiencing falls (1,775/3,238 vs. 773/2,075, OR 1.69, 95% CI 1.50-1.91, P <0.0001) and an increased risk for multiple falls (37.1 vs. 22.6%, OR 1.63, 95% CI 1.42-1.87, P <0.0001). Furthermore, compared to a creatinine clearance of ≥65ml/min, a creatinine clearance of <65ml/min was also associated with a significant increased multivariate controlled risk for hip fractures (OR 1.57, 95%CI 1.18-2.09, P =0.002), for radial fractures (OR 1.79, 95%CI 1.39-2.31, P =<0.0001), for total vertebral fractures (OR 1.31, 95%CI 1.19-1.55, P =0.003) and for fall-associated vertebral fractures (OR 1.24, 95% CI 1.03-1.54, P =0.031). Similar to community-dwelling elderly, in elderly men and women treated for osteoporosis a CrCl of less than 65ml/min is a significant and independent risk factor for falls. Furthermore, we could show for the first time that a low creatinine clearance in elderly men and women treated for osteoporosis is also associated with a significantly increased risk of vertebral, hip and radial fractures