Oral Bisphosphonate Use and All ‐Cause Mortality in Patients With Moderate–Severe (Grade 3B‐5D) Chronic Kidney Disease: A Population‐Based Cohort Study

This study examined the association between oBPs and all‐cause mortality in G3B‐5D CKD. This is a population‐based cohort study including all subjects with an estimated glomerular filtration rate (eGFR) <45/mL/min/1.73  m2 (G3B: eGFR<45/mL/min/1.73 m2 G4: eGFR 15 –29/mL/min/1.73 m2 G5: eGFR<15/mL/min/1.73 m2 G5D: hemodialysis) aged 40+ years from the UK Clinical Practice Research Datalink (CPRD) and the Catalan Information System for Research in Primary Care (SIDIAP). Previous and current users of other anti ‐osteoporosis drugs were excluded. oBP use was modeled as a time‐varying exposure to avoid immortal time bias. Treatment episodes in oBP users were created by concatenating prescriptions until patients switched or stopped therapy or were censored or died. A washout period of 180 days was added to (date of last prescription +180 days). Propensity scores (PSs) were calculated using prespecified predictors of mortality including age, gender, baseline eGFR, socioeconomic status, comorbidities, previous fracture, co‐medications, and number of hospital admissions in the previous year. Cox models were used for PS adjustment before and after PS trimming (the first and last quintiles). In the CPRD, of 19,351 oBP users and 210,954 non‐oBP users, 5234 (27%) and 85,105 (40%) deaths were recorded over 45,690 and 915,867 person‐years of follow‐up, respectively. oBP users had 8% lower m ortality risk compared to non‐oBP users (hazard ratio [HR] 0.9...
Source: Journal of Bone and Mineral Research - Category: Orthopaedics Authors: Tags: Original Article Source Type: research