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Association between loop diuretic use and fracture risk.

F Xiao1, X Qu, Z Zhai

  • 1Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|December 11, 2014
PubMed
Summary

Loop diuretic use is linked to a higher risk of total fractures and hip fractures. This meta-analysis confirms a significant association, advising caution for patients on these medications.

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Area of Science:

  • Pharmacology
  • Orthopedics
  • Epidemiology

Background:

  • Limited prospective randomized trial evidence exists on the skeletal effects of loop diuretics.
  • Previous observational studies have yielded conflicting results on loop diuretic use and fracture risk.

Purpose of the Study:

  • To conduct a meta-analysis of observational studies to assess the association between loop diuretic use and fracture risk.
  • To synthesize existing evidence to clarify the relationship between loop diuretics and skeletal health.

Main Methods:

  • A meta-analysis of prospective cohort and case-control studies was performed.
  • Data were sourced from PubMed, EMBASE, and OVID databases.
  • Relative risks (RR) with 95% confidence intervals (CI) were calculated using random-effects models.

Main Results:

  • Thirteen studies involving 842,644 participants and 108,247 fractures were analyzed.
  • Loop diuretic users showed a 15% increased risk of total fractures (RR 1.15, 95% CI 1.04-1.26).
  • A significant increased risk was observed for hip fractures (RR 1.14, 95% CI 1.08-1.19), but not for lower arm/wrist fractures (RR 0.99, 95% CI 0.93-1.05).

Conclusions:

  • Loop diuretics are significantly associated with an increased risk of total fractures and hip fractures.
  • The findings highlight a potential adverse skeletal effect of loop diuretic therapy.
  • Further research may be warranted to explore underlying mechanisms and clinical implications.