Hip Fracture Risk among Hemodialysis-Dependent Patients Prescribed Opioids and Gabapentinoids

Area of Science:

• Nephrology
• Gerontology
• Pharmacology

Background:

• Opioids are frequently prescribed to patients with end-stage kidney disease (ESKD), despite known hip fracture risks in the general population.
• The impact of opioids and gabapentinoids on hip fracture risk in ESKD patients on hemodialysis is not well understood.

Purpose of the Study:

• To investigate the association between opioid and gabapentinoid use and hip fracture risk in patients with ESKD undergoing hemodialysis.
• To differentiate between short-term and longer-term medication exposure.

Main Methods:

• A case-control study nested within the US Renal Data System (2009-2015).
• Identified hip fracture cases and matched them with controls among hemodialysis patients.
• Utilized conditional logistic regression to analyze medication exposure (opioids, gabapentinoids) and hip fracture risk, considering both long-term and new short-term use.

Main Results:

• Opioid use was significantly associated with an increased risk of hip fractures in hemodialysis patients (adjusted OR, 1.39).
• Both longer-term and new short-term opioid use demonstrated elevated hip fracture risk.
• No association was found between gabapentinoid use and hip fracture risk.

Conclusions:

• Opioid analgesics, encompassing both short-term and longer-term use, are linked to an increased incidence of hip fractures in US patients dependent on hemodialysis.
• Gabapentinoids did not show a significant association with hip fracture risk in this population.