Renal Function, Bone Mineral Density, and Fractures in a Population of Puerto Rican Females ages 50 – 90 years: A population-based study of the Latin American Vertebral Osteoporosis Study (LAVOS) – Puerto Rico Site

Presentation Number: SAT-249
Date of Presentation: June 15th, 2013

Loida Alejandra Gonzalez-Rodriguez*1, Monica Alexandra Vega2, Katya Giovanetti3 and Lillian Haddock4
1University of Puerto Rico School of Medicine, San Juan, PR, 2University of Puerto Rico, School of Medicine, San Juan, PR, 3Puerto Rico Clinical and Translational Research Consortium, San Juan, PR, 4Univ of Puerto Rico, San Juan, PR

Abstract

PURPOSE: To determine the prevalence of renal dysfunction in a group of Puerto Rican women (50-90 years old) and determine the relationship between renal function, BMD, and the prevalence of vertebral and non-vertebral fractures in this population.

METHODS: Data from the 400 subjects’ database of the LAVOS, Puerto Rico site was reviewed. Patient’s medical history, anthropometric data, current medications, laboratory results, and DXA results was extracted. Renal dysfunction, and corresponding CKD stages, were classified according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Estimated glomerular filtration rate (GFR) and creatinine clearance (CrCl) were calculated using the MDRD and Cockroft-Gault equations, respectively. Clinical features related to osteoporosis and BMD were defined by WHO criteria.  χ2 analyses and Fisher’s exact test were used in order to examine significant differences in the prevalence of vertebral and non-vertebral fractures by stage of renal dysfunction. Unadjusted Spearman’s correlations were computed to examine relationships between BMDs, GFR, and CrCl. To test for significant differences in the distributions of GFR, CrCl, and BMD across important categorical data we implemented non-parametric Wilcoxon rank-sum or Kruskal Wallis equality-of-population tests.  Statistical significance was set at P <0.05.

RESULTS: The prevalence of the different stages of renal dysfunction according to MDRD were 2.25% stage 1, 58.72% stage 2, 37.75% stage 3, 1.25% stage 4. The prevalence according to CG were 8.75% stage 1, 54.25% stage 2, 35.25% stage 3, and 1.75% stage 4. There is a strong correlation between BMD and renal function when using the CG equation that is not seen when using the MDRD equation (p<0.001). Similarly, there is a strong association between mild renal dysfunction and vertebral [OR 2.11 (1.08 – 4.13)] and non-vertebral fractures [OR 1.86 (1.10 – 3.14)] when using the CG equation that persisted after adjustments for multiple variables.     

CONCLUSIONS:  Our study found a high prevalence of mild renal dysfunction in a sample of postmenopausal women in Puerto Rico. When using the CG equation to estimate CrCl in this population, there is a strong association between renal function, BMD, and vertebral and non-vertebral fractures. Mild to moderate renal dysfunction is associated with BMD, vertebral, and non-vertebral fractures in this population as seen in previous studies from other populations.

 

Nothing to Disclose: LAG, MAV, KG, LH