A NEW study has uncovered a nuanced relationship between alpha blocker (AB) use and the risk of fractures in patients with chronic kidney disease (CKD), emphasising the need for caution, especially in female patients. Researchers analysed data from over 115,000 Japanese patients between 2008 and 2021 to evaluate the impact of ABs prescribed for hypertension (HT) and voiding dysfunction (VD) on fracture risk.
The study revealed no increased fracture risk in males prescribed ABs for either HT or VD compared to non-AB users. However, in females, while ABs for HT did not elevate fracture risk, their use for VD significantly heightened the likelihood of fractures, with a hazard ratio of 2.28. This distinction highlights the potential vulnerability of female CKD patients to fracture risk under specific AB treatments.
The findings are particularly significant given CKD patients often face refractory hypertension and urinary complications, leading to frequent AB prescriptions. With an aging population and rising CKD prevalence, understanding such gender-specific risks is critical for safe prescribing practices.
The study authors urge healthcare professionals to approach AB use in CKD patients cautiously, particularly when treating voiding dysfunction in women. Tailored treatment plans, comprehensive risk assessments, and alternative therapies should be considered to minimise fracture risk in this vulnerable group.
These insights pave the way for further research into gender-specific responses to antihypertensive therapies and their broader implications in CKD management.
Aleksandra Zurowska, EMJ
Reference
Sunohara K et al. Association between alpha blocker use and the risk of fractures in patients with chronic kidney disease: a cohort study. BMC Nephrol. 2024;DOI: 10.1186/s12882-024-03892-5.
