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Fracture risk in dialysis and kidney transplanted patients: a protocol for systematic review and meta-analysis

Aboubacar Sidibé1, Lynne Moore2, Sonia Jean3

  • 1Centre de Recherche du CHU de Québec, Hôpital Hôtel-Dieu de Québec, Division of Nephrology, Endocrinology and Nephrology Axis, Faculty and Department of Medicine, Laval University, 10 McMahon, Québec City, Québec, G1R 2J6, Canada.

Systematic Reviews
|February 23, 2017
PubMed

Insights

Patients with chronic kidney disease (CKD) face higher fracture risks. This systematic review compares fracture risks in hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT) patients to guide preventive strategies.

Area of Science:

  • Nephrology
  • Orthopedics
  • Epidemiology

Background:

  • Chronic kidney disease (CKD) significantly elevates fracture and cardiovascular mortality risks.
  • Patients undergoing renal replacement therapy (hemodialysis [HD], peritoneal dialysis [PD], kidney transplantation [KT]) exhibit higher fracture incidence than the general population.
  • Uncertainty exists regarding the comparative fracture risk among HD, PD, and KT patient groups.

Purpose of the Study:

  • To systematically review and compare fracture risks across different renal replacement therapy modalities: HD vs. PD, HD vs. KT, and PD vs. KT.
  • To assess the risk of cardiovascular mortality following a fracture in these patient groups.
  • To identify patient populations with the highest fracture risk to inform preventive strategies.

Main Methods:

  • A systematic review of observational studies and randomized controlled trials (RCTs) will be conducted.
  • Searches will cover major databases (MEDLINE, Embase, Web of Science, Cochrane Library) and gray literature.
  • Risk of bias will be assessed using ROBINS-I and Cochrane handbook tools; evidence quality will be evaluated using GRADE. Pooled relative risks will be calculated using random-effect models.

Main Results:

  • This systematic review will synthesize pooled data on fracture risk in dialysis and kidney transplantation patients.
  • Comparative risk data between HD, PD, and KT groups will be analyzed.
  • The analysis aims to quantify fracture risk and associated cardiovascular mortality post-fracture.

Conclusions:

  • The findings will provide crucial pooled data to guide the implementation of targeted preventive strategies for fracture in CKD patients undergoing RRT.
  • Identifying specific RRT groups with the highest fracture risk is a key objective.
  • Potential heterogeneity in observational studies may be a limitation.
Abstract

Keywords:
FracturesHemodialysisKidney transplantationPeritoneal dialysis

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