来自以色列一项大型健康计划的绝经后骨质疏松症女性的肾功能损害

Renal impairment among postmenopausal women with osteoporosis from a large health plan in Israel.

作者信息

Yu Jingbo, Goldshtein Inbal, Shalev Varda, Chodick Gabriel, Ish-Shalom Sophia, Sharon Ofer, Modi Ankita

机构信息

Center for Observational and Real-world Evidence, Merck & Co, Inc., 600 Corporate Drive, Lebanon, NJ, 08833, USA,

出版信息

Arch Osteoporos. 2015;10:210. doi: 10.1007/s11657-015-0210-y. Epub 2015 Mar 10.

DOI:10.1007/s11657-015-0210-y

PMID:25753617

Abstract

UNLABELLED

Bisphosphonates are a first-line treatment for osteoporosis but require adequate renal function. We estimated the prevalence of renal impairment among osteoporotic women in Israeli. Approximately 2.3 % of women had renal impairment at a level that makes them inappropriate for bisphosphonate use, demonstrating the need for alternative therapies for osteoporosis treatment.

PURPOSE

The purpose of this study is to estimate the prevalence of renal impairment among postmenopausal osteoporotic women within a large Israeli health plan.

METHODS

This was a retrospective analysis of Maccabi electronic medical records, including Israeli women aged ≥55 with either an osteoporosis diagnosis or osteoporosis-related fracture between January 1, 2007, and December 31, 2011. The estimated glomerular filtration rate (eGFR), which was calculated from the lowest serum creatinine levels reported during the study period, was used to classify stage 1-5 renal impairment: normal ≥90, mild 60-89, moderate 30-59, severe 15-29, and failure <15 mL/min/1.73 m(2), respectively. Outcomes were distributions of renal impairment across the study population and stratified by age and osteoporosis-defining event.

RESULTS

A total of 15,608 patients met all eligibility criteria. Patients with stage 1-5 renal function accounted for 25.2, 54.9, 18.5, 1.2, and 0.3 %, respectively, of all patients. Of osteoporotic patients, 2.3 % had eGFR levels (<35 mL/min/1.73 m(2)) that make them inappropriate for bisphosphonate use. This rate was 1.6 % among patients with an osteoporosis diagnosis and 3.8 % among patients with osteoporosis-related fracture. Within the group of renally impaired patients, older patients were overrepresented. Of the fracture group, patients with hip fractures had a higher prevalence of renal dysfunction (9.3 %) than those having vertebral fractures (3.2 %) or other fractures (2.0 %).

CONCLUSIONS

Among postmenopausal women with osteoporosis, 2.3 % had renal impairment which makes them inappropriate for bisphosphonate use in Israel.

摘要

未标注

双膦酸盐是骨质疏松症的一线治疗药物，但需要足够的肾功能。我们估计了以色列骨质疏松症女性中肾功能损害的患病率。约2.3%的女性存在肾功能损害，其程度使其不适合使用双膦酸盐，这表明需要有骨质疏松症治疗的替代疗法。

目的

本研究的目的是估计以色列一个大型健康计划中绝经后骨质疏松症女性肾功能损害的患病率。

方法

这是一项对马卡比电子病历的回顾性分析，纳入了2007年1月1日至2011年12月31日期间年龄≥55岁、患有骨质疏松症诊断或骨质疏松症相关骨折的以色列女性。根据研究期间报告的最低血清肌酐水平计算的估计肾小球滤过率（eGFR）用于将1 - 5期肾功能损害分类：正常≥90、轻度60 - 89、中度30 - 59、重度15 - 29以及肾衰竭<15 mL/分钟/1.73 m²。结果是整个研究人群中肾功能损害的分布情况，并按年龄和骨质疏松症定义事件进行分层。

结果

共有15608名患者符合所有入选标准。1 - 5期肾功能患者分别占所有患者的25.2%、54.9%、18.5%、1.2%和0.3%。在骨质疏松症患者中，2.3%的患者eGFR水平（<35 mL/分钟/1.73 m²）使其不适合使用双膦酸盐。在骨质疏松症诊断患者中该比例为1.6%，在骨质疏松症相关骨折患者中为3.8%。在肾功能受损患者组中，老年患者占比过高。在骨折组中，髋部骨折患者肾功能不全的患病率（9.3%）高于椎体骨折患者（3.2%）或其他骨折患者（2.0%）。