Journal of Orthopaedic Reports (Sep 2023)

Association between statin use and fractures among dialysis patients in the north of the West Bank in 2021

  • Ahmad Farhoud,
  • Seraj Tijani,
  • Sojod Abualrub,
  • Ali Shakhshir,
  • Mohanad Hassan,
  • Zakaria Hamdan,
  • Naim Kittana,
  • Basma Damiri

Journal volume & issue
Vol. 2, no. 3
p. 100171

Abstract

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Introduction: Hip fractures are associated with higher morbidity and mortality among dialysis patients than among the general population. Statins reduce the risk of hip and bone fractures. However, this protective effect has not been studied in dialysis patients. Methods: Hemodialysis patients from hemodialysis centers located in the north of the West Bank were recruited (N ​= ​713) in a cross-sectional study in 2021. A statin user is a patient who has used statin for at least one year. The patient's medical records and an interview-administered structured questionnaire were used. Adjusted multiple logistic regression examined the association between statin use and fractures. A p-value less than 0.05 was considered statistically significant. Results: The final sample size was 529 patients, 184 were excluded, 60.7% were males, 54.4% were statin users, 76.1% were always adherent to their statin, and 75.3% used moderate-intensity statin. Statin users who were always adherent to their dose had a significantly lower risk of hip fractures (OR ​= ​0.090, p-value ​= ​0.026) than rarely adherent patients. In addition, patients who were always adherent with their statin dose (OR ​= ​0.188, p-value ​= ​0.007) or sometimes adherent (OR ​= ​0.171, p-value ​= ​0.022) had a significantly lower risk of having other bone fractures after dialysis than the rarely adherent counterparts. There were no differences between high and moderate-intensity statins regarding hip fracture effects (p-value >0.05). Moreover, the increased duration of dialysis significantly increased the risk of hip fractures (OR ​= ​1.349, p-value ​= ​0.003). Conclusion: The results of this study suggest that adherence to statin therapy was associated with decreased risk of hip fractures and other bone fractures among hemodialysis patients. These results could be the initial evidence of the protective effect against a vital health hazard among dialysis patients. This might ultimately contribute to re-considering the current statins prescription practice for dialysis patients. Further studies are recommended.

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