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Can lumbar spine bone mineral density predict readmission in denosumab-treated patients with chronic kidney disease?
  1. Ben-Chung Cheng1,3,
  2. Ying-Chou Chen2
  1. 1Department of Nephrology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  2. 2Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
  3. 3Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
  1. Correspondence to Dr Ying-Chou Chen, Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Dist., Kaohsiung 833, Taiwan; r820713{at}


This study investigated whether bone mineral density (BMD) affects readmission risk in patients with chronic kidney diseases (CKD) who received denosumab therapy. The study design was a retrospective case review of patients with CKD. Baseline age, sex, and body mass index were recorded for all patients included in the study. All comorbidities were recorded. All subjects underwent dual energy X-ray absorptiometry assay of the lumbar spine and right hip for BMD. The primary outcome was readmission. Predictive variables were categorized and compared between readmitted and non-readmitted patients. Logistic regression was used for multivariable analysis. A total of 121 patients with CKD who received denosumab therapy were enrolled. Of these, 29 were readmitted within 2 years, and 92 had no readmission. The lumbar BMD differed between the readmission (−2.94±0.68) and non-readmission (−2.09±1.48) groups. The readmission group had a lower T score than the non-readmission group. When adjusted for potential confounding factors, a decreased lumbar BMD had a higher readmission risk. When the cut-off points determined by receiver operating characteristic curve analysis were applied, the most precise point was set at a T score of −3. Osteoporosis in patients with CKD is associated with a high risk of readmission; the best predictor after denosumab therapy was the lumbar spine T score. A lower T score (especially if <−3) was associated with a higher probability of fracture readmission. It is essential to optimize primary and secondary prevention in these patients to improve their quality of life.

  • Kidney
  • Kidney Failure, Chronic
  • Osteoporosis
  • Knowledge

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  • Contributors B-CC designed and performed the research; and Y-CC analyzed the data and wrote the final article.

  • Competing interests None declared.

  • Ethics approval This retrospective study was approved by the Institutional Review Board of our hospital. Informed consent was waived because of the retrospective nature of this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The data set supporting the conclusion of this article is available on request from the corresponding author.