Osteoporosis & bone health

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

Osteoporos IntPublished Prospective cohort study

Main finding · Fracture risk per 10 nmol/L increment in serum 25(OH)DResult — go to the resultAdjusted hazard ratio 0.83 95% CI 0.68–0.99

Authors' 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.

Study context

Population
Stable outpatients undergoing maintenance hemodialysis49 (16.8%) fractures
Participants
292 outpatients
Exposure
Lower vs higher serum 25D
Outcome
Incidence of new fragility fractures
Follow-up
Median 24 months
Methodological detailsmultivariate Cox regression
  • Multivariate Cox regression

Main finding

As reported in the abstract

Fracture risk per 10 nmol/L increment in serum 25(OH)D · median 24 months

Adjusted hazard ratio

0.83

95% CI 0.68–0.99

P = 0.046

10 nmol/L increment in 25(OH)D
aHR 0.83 (95% CI 0.68–0.99); P = 0.046

Per 10 nmol/L increment in serum 25, as printed

Observational data: associations, not effects.

Further findings

OutcomeLower-25(OH)DHigher-25(OH)DaHR (95% CI)P value
Cumulative fracture incidence by median 25(OH)D · median 24 months24.3%11.9%1.87 (1.02–3.42)P = 0.041

Original publication

Impact of serum 25-hydroxyvitamin D levels on fragility fractures in patients undergoing chronic hemodialysis. Osteoporos Int. Published 28 July 2026. doi:10.1007/s00198-026-08160-w

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