Risk factors for osteonecrosis of the jaw in patients with chronic kidney disease: a nested case-control study
Authors' conclusion
These findings suggest that anti-resorptive drugs for tumor-related disorders and oral corticosteroids are associated with ONJ risk in CKD patients.
Study context
- Population
- Chronic kidney disease (CKD) patients identified by estimated glomerular filtration rate (eGFR) measurements in a large Japanese administrative database; median age 72 yr, 66.7% maleafter matching
- Participants
- 375 patients
- Comparison
- Osteonecrosis of the jaw (ONJ) cases vs matched controls
- Casesn = 75
- Outcome
- Risk factors for ONJ in CKD patients
Methodological detailscontrols matched 1:4 by age and sex, Japanese administrative database
- Controls matched 1:4 by age and sex
- Japanese administrative database
Main finding
As reported in the abstract
Factors associated with ONJ risk (multivariate analysis)
Anti-resorptive drugs for tumor-related disorders: OR (95% CI 8.81-634.39), p<.001
74.74
Oral corticosteroids: OR (95% CI 3.34-52.33), p<.001
13.23
Observational data: associations, not effects.
Further findings
ONJ incidence in CKD patients · median follow-up 2.9 yr
- ONJ cases among 597 026 CKD patients
- 75
- Incidence rate
- 3.27 per 100 000 patient-years
Bisphosphonate use stratified by indication
- Bisphosphonates for tumor-related disorders: OR (95% CI 2.47-313.29), p<.01
- 27.80
- Bisphosphonates for osteoporosis: OR (95% CI 0.19-2.92), p=.67
- 0.74
Use of bisphosphonates and denosumab for tumor-related disorders
- Significantly higher in cases than controls
Original publication
Risk factors for osteonecrosis of the jaw in patients with chronic kidney disease: a nested case-control study. J Bone Miner Res. Published 5 December 2024. doi:10.
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