Increased Risk of Osteoporosis in Patients With Nephrotic Syndrome. A Nationwide Population-Based Retrospective Cohort Study

Abstract Corticosteroid (CS) is commonly used in nephrotic syndrome (NS) and a risk factor for osteoporosis. We evaluated the risk of osteoporosis in patients with nephrotic syndrome using a nationwide population-based dataset. After adjusting for covariates, osteoporosis risk was found to be 3.279 times greater in the NS cohort than in the non-NS cohort, when measured over 11 years after NS diagnosis. Stratification revealed that age older than 18 years, congestive heart failure, hyperlipidemia, chronic kidney disease, liver cirrhosis, and NS-related disease including diabetes mellitus, hepatitis B infection, hepatitis C infection, lymphoma, and hypothyroidism, increased the risk of osteoporosis is when comparing the NS cohort with the non-NS cohort. Additionally, osteoporosis risk was significantly higher in NS patients with CS use (aHR = 3.397). The risk of osteoporosis in NS patients was positively associated with risk of hip and vertebral fracture (aHR = 2.130 and 2.268, respectively). A significant association exists between NS and subsequent risk for osteoporosis. Therefore NS patients, particularly those treated with CS, should be evaluated for subsequent risk of osteoporosis.