Abstract
Three hundred and four chronic renal failure patients (173 males, 131 females) given maintenance HD treatment at Narita Memorial Hospital and two affiliated institutions, were studied in this investigation of fractures in hemodialysis (HD) patients. Fractures of patients since they began HD therapy were surveyed in the period between February 25 and May 31, 1995. The results showed 47 patients (30 males, 17 females) had a history of fractures. Fractures were found in a total of 37 males and 27 females. In both sexes, fractures were more common in the third decade or younger, rather than among elderly patients 60 years or older. The incidence of fractures (%) in both sexes significantly increased with the individual history of HD treatment (years) and showed a high positive correlation (r>0.9). Fracture locations were as follows: ribs, the most common fracture, in 9 males and 11 females; followed by fractures of the clavicle, scapula and heel (5 cases each among males); and forearm, femur and toe fractures (3 cases each among females). In males there were 5 cases each of fracture of the scapula and heel, neither of which is markedly affected by osteoporosis. Not even one such fracture was found among females. The most frequent pathological fracture among both sexes involved the ribs. No significant sex difference was found in any age bracket in the incidence of fractures. There was no significant sex difference on total body bone mineral density using Z score analysis. Based on the above-mentioned findings, it was conspeculated that aside from bone mineral density, daily life activity is one of the factor that increases the incidence of fractures.
