Mapping Fracture Risk Assessment and Osteoporosis Management in Chronic Kidney Disease: Insights from a National Survey of 1208 Nephrologists

E-Poster

https://storage.unitedwebnetwork.com/files/1099/d1a4416faa32f0b125787ac21fb1374d.pdf

Abstract Title

First Name *

Vijay

Last Name *

Kher

Co-author 1

Vijay Kher abstractsubmissionnow@gmail.com Epitome Kidney Urology Institute and Lions Hospital Nephrology Delhi

Co-author 2

Georgi Abraham georgi2345678@jkdjd.cm MGM Healthcare Nephrology Chennai

Co-author 3

Abhay Sadre fghjkf@ufhyfk.cj Ruby Hall Clinic Nephrology Pune

Co-author 4

Dinesh Khullar ertyu5567@jdhd.cm Max Superspeciality Hospital, Saket Nephrology Delhi

Co-author 5

Sishir Gang dfghjd@ufuf.cn Muljibhai Patel Urological Hospital Nephrology Nadiad

Co-author 6

Jatin Kothari fydhd@udhd.ckm Nanavati Max Superspeciality Hospital Nephrology Mumbai

Co-author 7

Rajasekhara Chakravarthi dfghfjd@jf.com Yashoda Hospitals, Hitec City Nephrology Hyderabad

Co-author 8

Vishwanath S gfhfjf@jffjf.cm Manipal Hospital Nephrology Bangalore

Co-author 9

Anil Kumar BT hfjgkg@kifugf.vm BGS Gleneagles Hospital Nephrology Bangalore

Co-author 10

Rohit Rungta fghjk@kifiof.vm Medica Superspecialty Hospital Nephrology Kolkata

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

We aimed to explore fracture risk assessment and osteoporosis management in Chronic Kidney Disease (CKD) patients, based on insights from nephrologists. Understanding the approaches used by nephrologists can lead to improved patient care and management strategies

Methods

We developed customised technological response system for a cross-sectional survey, covering fracture risk assessment methods, bone mineral density estimation frequency, bisphosphonates' side effects, and preferred high-risk fracture drug choice for CKD patients was developed, which was validated by the subject thought leaders. An expert nationwide panel, across India, comprising 1208 nephrologists (OSTEOMAP Study group), responded to the questionnaire. Anonymised data were statistically analysed by GraphPad software version 10.0.0

Results

The study involved 1208 nephrologists with a combined experience of 24000 man-years. 97% (1173) believed in osteoporosis screening, with 80.7% (947) using DEXA alone or with other modalities (bone turnover markers, clinical history of fractures) for fracture risk assessment. 19.2% (226) used alternative tools (screening in BMD community camps, clinical history of fractures). Opinions on BMD assessment frequency varied, with 58% (701) annually and 31% (374) biannually. Among those using DEXA for risk assessment (n=947), frequency preferences were similar (p=0.75 ns). 82% (991) of nephrologists reported gastrointestinal irritation as a side effect of bisphosphonates. In high fracture-risk CKD patients, 64.4% (778) preferred primary denosumab, 27.5% (332) sequential denosumab and bisphosphonates, and 5.5% (66) only bisphosphonates. Nephrologists choosing denosumab were significantly associated with DEXA use for risk assessment (p=0.0024) (Fig)

Conclusions

The OSTEOMAP study underscores the importance of osteoporosis screening with DEXA, supported by 97% of nephrologists. Denosumab emerged as the preferred drug for high-risk CKD patients, while opinions on BMD assessment frequency varied. These findings provide valuable insights for optimizing fracture risk management in CKD patients

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