Risk of hip fracture in patients on dialysis or kidney transplant: a meta-analysis of 14 cohort studies

Figures & data

Figure 1 The steps of the literature selection.

Table 1 Characteristics of 14 retrospective studies included in present meta-analysis

First author’s name	Year	Country/region	Study period	Number of dialysis or KT (n)	Type	Age (years)	Male (%)	Follow-up (years)	Follow-up (person-years)	Number of hip fractures (n)	Proportion of hip fracture (%)	Incident rate of hip fracturea	Study quality
Alem et al^Citation4	2000	USA	1989–1996	326,464	PD	59.5	55.9	1.97	643,831	6,542	2.00	10.16	7
Arneson et al^Citation10	2013	USA	2010	203,857	HD	67	54.4	1	175,422	2,912	1.43	16.6	7
Ball et al^Citation7	2002	USA	1990–1999	41,095	HD+PD	47	57.4	2.98	147,989	424	1.03	2.9	6
				59,944	KT	47	57.4	2.98	166,778	547	0.91	3.3
Chen et al^Citation12	2014	Taiwan	1998–2009	59,457	HD	67	49.21	3	187,353	2,548	4.29	13.6	8
				4,667	PD	62	46.54	3	6,240	39	0.84	6.25
Coco and Rush^Citation5	2000	USA	1988–1998	1,272	HD+PD	58	49	3.17	4,039	56	4.40	13.9	8
Ferro et al^Citation21	2015	England	2001–2013	21,769	KT	NA	NA	4.71	112,512	173	0.79	1.54	8
Lin et al^Citation13	2014	Taiwan	1999–2006	47,986	HD	54.5	48.3	4.14	198,172	1,843	3.84	9.3	8
				3,487	PD	54.5	41.6	4.14	14,634	60	1.72	4.1
Maruyama et al^Citation14	2014	Japan	2009–2010	185,277	HD	66	61.9	1	NA	1,586	0.86	11.7	7
Nair et al^Citation11	2013	USA	1996–2009	409,040	HD+PD	76	51.9	3	610,478	17,887	4.37	29.3	8
Naylor et al^Citation22	2016	Canada	2003–2013	2,385	KT	50	63.1	10	21,579	41	1.70	1.9	8
Rudser et al^Citation9	2007	USA	1990–2003	16,328	HD	50	45.4	2.44	39,785	370	2.27	9.3	7
Stehman-Breen et al^Citation19	2000	USA	1993–1996	4,372	HD	59.7	51.7	2.86	12,014	95	2.17	7.91	6
				102	PD	NA	NA	2.86	288	1	0.98	3.47
				478	KT	NA	NA	2.86	1,351	4	0.84	2.96
Sukumaran et al^Citation20	2014	USA	1997–2010	69,740	KT	51	61	2.2	155,341	597	0.86	3.8	7
Wakasugi et al^Citation6	2013	Japan	2007–2008	128,141	HD	64.3	61.9	1	126,912	1,437	1.12	11.32	7

Note:

a per 1,000 person-years.

Abbreviations: HD, hemodialysis; KT, kidney transplantation; PD, peritoneal dialysis; NA, not available.

Figure 2 Proportions (%) of hip fracture in patients on dialysis or KT.

Note: Weights are from random effects analysis.
Abbreviations: HD, hemodialysis; KT, kidney transplantation; PD, peritoneal dialysis.

Figure 3 Incidence rate of hip fracture (per 1,000 person-years) in patients on dialysis or KT.

Note: Weights are from random effects analysis.
Abbreviations: HD, hemodialysis; KT, kidney transplantation; PD, peritoneal dialysis.

Figure 4 RR of hip fracture in patients on dialysis compared to the general population.

Note: Weights are from random effects analysis.
Abbreviation: RR, relative risk.

Figure 5 RR of hip fractures in patients on HD compared to those on PD.

Note: Weights are from random effects analysis.
Abbreviations: HD, hemodialysis; PD, peritoneal dialysis; RR, relative risk.

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