Erythropoietin Increases Hip Fracture Risk in Hemodialysis Patients

Dr. Umair Haider | July 2021

Higher erythropoietin (EPO) doses are associated with increased risk for hip fractures in patients receiving hemodialysis (HD). Compared with EPO doses less than 50 units/kg/week, doses of 50-149, 150-299, and 300 or more units/kg/week were associated with 8%, 22%, and 41% higher risk for hip fracture, respectively, Sukanya Suresh, Ph.D. and colleagues reported in the Journal of Bone and Mineral Research.

These analyses also confirmed known hip fracture risk factors, including older age, female sex, White race, low serum albumin, and low body mass index. With respect to medications, proton pump inhibitors (PPIs), antiarrhythmics, cardiac stimulants, and antidepressants were associated with increased hip fracture risk, whereas cinacalcet, phosphate binders, and vitamin D correlated with decreased risk.

Dr. Suresh and colleagues concluded that the findings of the study justifies using minimal doses of EPO to treat patients of renal failure and use EPO to improve the anemia rather than correcting it.


Source: Suresh S, Wright EC, Wright DG, Abbott KC, Noguchi CT. Erythropoietin treatment and the risk of hip fractures in hemodialysis patients. J Bone Miner Res. Published online May 5, 2021. doi:10.1002/jbmr.4297