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Summary <p>In this study, we investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels and fracture risk in patients undergoing hemodialysis. Our findings suggest that maintaining adequate serum 25(OH)D levels may be important for preserving bone health even in patients undergoing hemodialysis with impaired renal activation of vitamin D.</p> Purpose <p>Vitamin D deficiency and fragility fractures are highly prevalent among patients undergoing hemodialysis. Low serum 25(OH)D levels are associated with an increased risk of fractures in the general population; however, whether this association persists in patients undergoing hemodialysis with suppressed renal activation of 25(OH)D remains unclear.</p> Methods <p>Serum 25(OH)D levels were measured in 292 stable outpatients undergoing maintenance hemodialysis. The association between baseline 25(OH)D status and the incidence of new fragility fractures was investigated.</p> Results <p>During the median follow-up period of 24&#xa0;months, 49 (16.8%) fractures occurred. Multivariate Cox regression analyses revealed the significant association of a 10&#xa0;nmol/L increment in serum 25(OH)D levels with a reduced risk of fractures (adjusted hazard ratio [aHR] 0.83, 95% confidence interval [CI] 0.68–0.99, <i>p</i> = 0.046). When patients were stratified by the median 25(OH)D level, the cumulative fracture incidence rates were 24.3% and 11.9% (aHR 1.87, 95% CI 1.02–3.42, <i>p</i> = 0.041) in the lower- and higher-25(OH)D groups, respectively.</p> Conclusion <p>Lower serum 25(OH)D levels were independently associated with an increased risk of fracture, regardless of traditional fracture risk factors or variables affecting vitamin D status in patients undergoing hemodialysis with impaired renal vitamin D activation. This finding suggests that circulating 25(OH)D levels may serve as a predictor of fracture risk in patients undergoing hemodialysis.</p>

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Impact of serum 25-hydroxyvitamin D levels on fragility fractures in patients undergoing chronic hemodialysis

  • 期刊论文

  • 发表日期：

    2026年7月28日

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  • Mayuko Hori,
  • Hiroshi Takahashi,
  • Chika Kondo,
  • Shigehiro Tokoroyama,
  • Akiko Kanda,
  • Kenta Furuhashi,
  • Yoshiko Mori,
  • Yuichi Shirasawa,
  • Asami Takeda,
  • Kunio Morozumi,
  • Shoichi Maruyama

摘要

Summary

In this study, we investigated the association between serum 25-hydroxyvitamin D (25(OH)D) levels and fracture risk in patients undergoing hemodialysis. Our findings suggest that maintaining adequate serum 25(OH)D levels may be important for preserving bone health even in patients undergoing hemodialysis with impaired renal activation of vitamin D.

Purpose

Vitamin D deficiency and fragility fractures are highly prevalent among patients undergoing hemodialysis. Low serum 25(OH)D levels are associated with an increased risk of fractures in the general population; however, whether this association persists in patients undergoing hemodialysis with suppressed renal activation of 25(OH)D remains unclear.

Methods

Serum 25(OH)D levels were measured in 292 stable outpatients undergoing maintenance hemodialysis. The association between baseline 25(OH)D status and the incidence of new fragility fractures was investigated.

Results

During the median follow-up period of 24 months, 49 (16.8%) fractures occurred. Multivariate Cox regression analyses revealed the significant association of a 10 nmol/L increment in serum 25(OH)D levels with a reduced risk of fractures (adjusted hazard ratio [aHR] 0.83, 95% confidence interval [CI] 0.68–0.99, p = 0.046). When patients were stratified by the median 25(OH)D level, the cumulative fracture incidence rates were 24.3% and 11.9% (aHR 1.87, 95% CI 1.02–3.42, p = 0.041) in the lower- and higher-25(OH)D groups, respectively.

Conclusion

Lower serum 25(OH)D levels were independently associated with an increased risk of fracture, regardless of traditional fracture risk factors or variables affecting vitamin D status in patients undergoing hemodialysis with impaired renal vitamin D activation. This finding suggests that circulating 25(OH)D levels may serve as a predictor of fracture risk in patients undergoing hemodialysis.