A RECENT study has identified an increased risk of fractures in female chronic kidney disease (CKD) patients using alpha blockers (ABs) for voiding dysfunction (VD), highlighting the need for caution when prescribing these medications.
The population-based cohort study analysed data from over 65,000 CKD patients in Japan between 2008 and 2021. Participants were divided into groups based on AB use for hypertension (HT) or VD, as well as a non-AB control group. The study evaluated the risk of fractures, defined as hospitalisation due to fractures, using a weighted Cox proportional hazard model.
In male patients, AB use did not significantly increase fracture risk in either the VD or HT groups compared to non-AB users. However, in females, ABs prescribed for VD were associated with a significantly higher risk of fractures, with a hazard ratio (HR) of 2.28 compared to ABs used for HT.
“These findings underscore the importance of tailoring alpha blocker prescriptions in CKD patients, particularly for females requiring treatment for voiding dysfunction,” the authors noted.
While ABs remain an important treatment option for CKD patients, this study suggests that their use in female patients with VD should be carefully monitored to minimise fracture risk. This highlights the need for personalised treatment approaches to optimise safety and outcomes in this vulnerable population.
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.
