Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: This study investigated whether bone mineral density (BMD) affects readmission risk in patients with CKD who received denosumab therapy.
Methods: The study design was a retrospective case review of CKD patients. Baseline age, sex, and body mass index (BMI) were recorded for all patients included in the study. All comorbidities were recorded. All subjects underwent dual energy X-ray absorptiometry assay of the lumbar spine and right hip for BMD. The primary outcome was readmission. Predictive variables were categorized and compared between readmitted and non-readmitted patients. Logistic regression was used for multivariable analysis.
Results: A total 121 patients with CKD who received denosumab therapy were enrolled. Of these, 29 were readmitted within 2 years, and 92 had no readmission. The lumbar BMD differed between the readmission (-2.94±0.68) and non-readmission group (-2.09±1.48). The readmission group had a lower T score than the non-readmission group. When adjusted for potential confounding factors, a decreased lumbar BMD had a higher readmission risk. When the cut-off points determined by receiver operating characteristic (ROC) curve analysis were applied, the most precise point was set at a T score of -3(Table).
Conclusion: Osteoporosis in CKD patients is associated with a high risk of readmission; the best predictor after denosumab therapy was the lumbar spine T score. A lower T score (especially if less than -3) was associated with a higher probability of fracture readmission. It is essential to optimize primary and secondary prevention in these patients to improve their quality of life.
|Table . Multivariable analysis of the odds ratios for readmission|
|Variables||Regression coefficient||S.E.||Wald||P- value||OR (95%CI)|
|Age (years)||-0.001||0.033||0.001||0.971||0.998 (0.936-1.065)|
|Body mass index (kg/m2)||-0.037||0.073||0.259||0.611||0.963 (0.836-1.111)|
|Spine fracture (number)||0.12||0.188||0.404||0.525||1.127 (0.779-1.631)|
|BMD (lumbar)||-0.673||0.248||7.369||0.007||1.960 (1.206-3.189)|
|BMD (Total hip)||-0.336||0.548||0.377||0.539||0.714 (0.244-2.090)|
|BMD (Femoral neck)||-0.165||0.587||0.079||0.779||0.847 (0.269-2.677)|
|Neurological disease||0.763||0.69||1.222||0.269||2.143 (0.555-8.289)|
|Diabetes mellitus||0.367||0.623||0.348||0.556||1.443 (0.426-4.897)|
|Cardiovascular disease||0.117||0.691||0.029||0.865||1.124 (0.290-4.357)|
|Pulmonary disease||-0.116||0.861||0.018||0.893||0.890 (0.165-4.813)|
|Liver disease||-0.705||0.832||0.717||0.397||0.4941 (0.097-2.526)|
|OR, odds ratio; SE, standard error|
To cite this abstract in AMA style:Chen YC Sr.. Can Lumbar Spine Bone Mineral Density Predict Readmission in Denosumab-Treated Chronic Kidney Disease Patients? [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/can-lumbar-spine-bone-mineral-density-predict-readmission-in-denosumab-treated-chronic-kidney-disease-patients/. Accessed October 31, 2020.
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