Coexistence of
chronic kidney disease (CKD) is regarded as a risk for
osteoporotic fracture particularly in postmenopausal women, not only because of increased
parathyroid hormone level but also uremic
sarcopenia. We examined the relationships of
cystatin C-based glomerular filtration rate (eGFRcys) and
creatinine-based GFR (eGFRcr), as well as their ratio with occurrence of
osteoporotic fracture in postmenopausal osteoporotic women. This cross-sectional study included 555 postmenopausal women with
osteoporosis. eGFRcr and eGFRcys were simultaneously measured, while occurrence of
osteoporotic fracture was obtained by a medical chart review. Patients with
osteoporotic fractures (n = 211) exhibited significantly lower levels of physical activity, eGFRcr, eGFRcys, and eGFRcys/eGFRcr ratios, while a higher percentage was CKD stage 3 or more, estimated by eGFRcr or eGFRcys (CKDcys), than those without (n = 344). Lower eGFRcys, but not lower eGFRcr, was independently associated with
osteoporotic fracture in the entire cohort and that association was retained in CKDcys patients. Of great interest, higher eGFRcr was associated with
osteoporotic fracture independent of eGFRcys in CKDcys patients. Furthermore, lower eGFRcys/eGFRcr ratio was independently associated with
osteoporotic fracture in both CKDcys patients and the entire cohort. eGFRcys reduction might be associated with
osteoporotic fracture in postmenopausal osteoporotic women, indicating the involvement of renal osteopathy in its occurrence. Furthermore, the association of higher, but not lower, eGFRcr with
osteoporotic fracture in CKDcys cases might be explained by underestimation of renal dysfunction by eGFRcr resulting from decreased muscle mass and quality in those patients.