FRAX

Background.

Chronic kidney disease (CKD) increase risk for fracture, however, the best method by which to identify those with CKD at high fracture risk is unknown. The World Health Organization Fracture Risk Assessment Tool (FRAX) was established to allow health providers to estimate individual 10-year probabilities of fragility-relatedfractures. At present, few studies have investigated hemodialysis patients via the application of FRAX. So the first purpose of this study was to analyze the characteristics of subjects with hemodialysis by using FRAX analysis.

Material and method

1. RESEARCH METHODOLOGY

A cross-sectional study will be conducted.

2.1. Study population

A total of 150 CKD on hemodialysis patients will be include; The GPower, version 3.1.2 was used to determine theminimal required sample sizewith an a level of .05 (5%), power of 0.95 (95%), 50% risk percentageof FRAX score in population and 65% in sample, the minimalrequired sample size are 145 patients(figure1).Participants will recruited at nephrology department, Kaohsiung Chang Gang Memorial Hospital.The inclusion criteria are those with CKD on hemodialysis and are a willingness toparticipate in the study and ability to read and provide informedconsent. As this project was based on a screening program, nospecific exclusion criteria were set.

2.2. Data collection and measurements

Each participant was interviewed by a well-trained researchassistant to complete the structured questionnaire, whichincluded the clinical risk factors (e.g. years of hemodialysis, a prior history of fracture, a parental history ofhip fracture, use of oral GC, rheumatoid arthritisand othersecondary causes of osteoporosis, current smoking, and alcoholintake 3 or more units daily) specifically for FRAX calculationtool andprotectionsfactors comprised physical activity and green tea drinking.A study flowchart of patient disposition is shown in Figure2.

2.3. Ethics statement

This study is approved by the local Institutional Review Boardof Chang Gung Memorial Hospital All participantsprovide written informed consent to participate in this study.

2.4. Statistical analysis

Data analysis performed with statistical software of R 3.4.1. Multiple regression models are used to analyzed the relationship between hemodialysis and non-hemodialysis patients after adjusting confounders. ANOVA test and Chi-square test are used in stratification analysis to clarify the interactions between independent variables and confounders.

Expected contributions to academic research, national development and other applications.

his is the first study to investigate the role of FRAX and hemodialysis in Taiwan. The more understanding of FRAX, the more therapeutic management could be advanced. With the expected results of the study, we hope to provide a more scientific basis for clinicians and practice guideline in the treatment of hemodialysis patients with fracture risk.