Trabecular Bone Score as a Marker of Skeletal Fragility Across the Spectrum of Chronic Kidney Disease: A Systematic Review and Meta-analysis
Authors' conclusion
CKD patients are characterized by an impairment of bone microarchitecture, as demonstrated by lower TBS values, across the whole spectrum of kidney disease. TBS can also be helpful in the discrimination of fracture risk, with lower values being correlated with a higher risk of prevalent and incident fractures.
Study context
- Population
- Patients with chronic kidney disease (CKD) (non-dialysis, dialysis, kidney transplant recipients); PubMed/Medline, EMBASE and Cochrane Library searched until July 2023
- Comparison
- CKD vs controls
- Outcome
- TBS as a marker of skeletal fragility across the spectrum of CKD
Methodological detailsrandom-effect model
- Random-effect model
Pooled result
As reported in the abstract
TBS vs controls
Each group vs controlsDifference (95% CI)P value
CKD not on dialysislower TBS in CKD
−0.057(−0.090 to −0.024)
P < 0.01Dialysislower TBS in dialysis
−0.106(−0.141 to −0.070)
P < 0.01KTRslower TBS in KTRs
−0.058(−0.103 to −0.012)
P = 0.01Further pooled results
| Outcome | Difference (95% CI) | P value | |
|---|---|---|---|
| TBS in dialysis patients with prevalent fracturesvs unfracturedLower TBS with prevalent fractures | −0.070 (−0.111 to −0.028) | P < 0.01 | |
| −0.15−0.1−0.0500.05Difference (linear scale) |
Incident fractures in non-dialysis patients, per SD decrease in trabecular bone score (TBS)
- Unadjusted HR per SD decrease: 1.45 (95%CI 1.05, 2.00), P = .02
- Fully FRAX-adjusted HR (nonsignificant trend): 1.26 (95%CI 0.88, 1.80), P = .21
TBS and fracture risk in kidney transplant recipients (KTRs)
- Some studies supported a correlation; results could not be pooled due to insufficient data
Original publication
Trabecular Bone Score as a Marker of Skeletal Fragility Across the Spectrum of Chronic Kidney Disease: A Systematic Review and Meta-analysis. J Clin Endocrinol Metab. Published 11 December 2023. doi:10.
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