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Fracture risk in patients treated with loop diuretics
L Rejnmark1, P Vestergaard, L Mosekilde
1Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus C, Denmark. rejnmark@post6.tele.dk
Journal of Internal Medicine
|December 13, 2005
Summary
Loop diuretics (LD) are associated with increased fracture risk, particularly hip fractures. Special attention is needed when initiating or stopping LD treatment due to potential fracture risk changes.
Area of Science:
- Pharmacology
- Epidemiology
- Bone Health
Background:
- Loop diuretics (LD) increase renal calcium excretion, but their impact on fracture risk is debated.
- Previous studies show conflicting results regarding the association between LD use and fracture risk.
Purpose of the Study:
- To evaluate the association between loop diuretic use and the risk of fractures.
- To investigate fracture risk in patients initiating, continuing, or discontinuing loop diuretic therapy.
Main Methods:
- Population-based pharmaco-epidemiological case-control study.
- Utilized nationwide computerized registers for exposure (LD use) and outcome (fracture) data.
- Included 64,699 fracture cases and 194,111 matched controls aged 40+.
Main Results:
- Ever use of LD was linked to a 51% increased risk of any fracture and a 72% increased risk of hip fracture.
- Adjusted analysis showed a 4% increase in any fracture risk and a 16% increase in hip fracture risk.
- Fracture risk varied based on current vs. former use and specific LD type (furosemide vs. bumetanide).
Conclusions:
- Loop diuretic treatment significantly impacts fracture risk.
- Patients initiating or discontinuing LD therapy require careful monitoring for increased fracture risk.