Fracture risk prediction in patients receiving dialysis
Authors' conclusion
We developed Dial-Frac, an easy-to-implement equation that predicts fracture risk in patients receiving maintenance dialysis.
Study context
- Population
- Adults aged 40–90 years receiving maintenance dialysis with an available parathyroid hormone (PTH) value, Ontario, Canada (2010–2017); mean age 66 years, 39% female, 12% previous fracture
- Participants
- 11,599 adults
- Outcome
- First major fracture (prediction tool Dial-Frac)
- Follow-up
- 3 years
Methodological detailsprediction model development, internal validation with 10-fold cross-validation, Fine and Gray subdistribution hazards models accounting for competing risk of death
- Prediction model development
- Internal validation with 10-fold cross-validation
- Fine and Gray subdistribution hazards models accounting for competing risk of death
Main finding
As reported in the abstract
Discrimination of Dial-Frac for fracture
Time-dependent AUC for fracture at 1 year
0.79
Time-dependent AUC for fracture at 3 years
0.71
Observational data: associations, not effects.
Further findings
Fracture incidence · 3 years
- Patients with a fracture
- 839 patients (7.2%)
- Fractures occurring in the first year
- 44%
- Hip fractures (most common)
- 299/839
Original publication
Fracture risk prediction in patients receiving dialysis. J Bone Miner Res. Published 19 August 2026. doi:10.
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