The authors reply

We appreciate the letter by Dr.  Sugiyama, which provides a potential mechanistic insight with regard to the relationship between chronic kidney disease and fracture risk.1 We agree with Dr. Sugiyama that lower estimated glomerular filtration rate is associated with a decline in physical activity, and as such, physical activity c ould be a confounder in the relationship between chronic kidney disease and bone mineral density. In our previous work, we found a 4-fold higher risk of low physical activity with chronic kidney disease, a greater magnitude than diabetes or nearly 2 decades of aging.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Letter to the Editor Source Type: research