High-potency statins are associated with reduced osteoporosis but increased fracture risk in chronic kidney disease (CKD) patients: a multi-center retrospective study
Authors' conclusion
High-potency statins are associated with lower osteoporosis diagnosis rates and fewer anti-osteoporotic medication prescriptions in CKD stages 3 and 4. The increased long-term fracture risk may reflect a diagnostic gap wherein lower osteoporosis detection contributes to under-treatment of bone fragility.
Study context
- Population
- Adults with CKD stages 3 or 4 initiating statin therapy, TriNetX US Collaborative Network
- Participants
- 873,180 matched patients
- Exposure
- High-potency vs low-potency statins
- Outcome
- Three primary outcomes: new osteoporosis diagnosis, anti-osteoporotic medication initiation, and incident fractures
- Follow-up
- 3-12 months and beyond 12 months
Methodological detailsmulticentre, 1:1 propensity-score matched, Cox and competing risk regression
- Multicentre
- 1:1 propensity-score matched
- Cox and competing risk regression
Main finding
As reported in the abstract
Co-primary: new osteoporosis diagnosis, anti-osteoporotic medication initiation and incident fractures · 3-12 months
High-potency vs Low-potencyHazard ratio (95% CI)
Osteoporosis diagnosis; 20.0% reduction
0.80(0.78–0.82)
Anti-osteoporotic medication prescriptions; 24.9% fewer
0.75(0.73–0.78)
Observational data: associations, not effects.
Further findings
Osteoporosis diagnosis and anti-osteoporotic medication prescriptions · beyond 12 months
- Associations (lower with high-potency statins) persisting beyond 12 months
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
High-potency statins are associated with reduced osteoporosis but increased fracture risk in CKD patients: a multi-center retrospective study. Osteoporos Int. Published 15 April 2026. doi:10.
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