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char = t;code = 116
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char = n;code = 110
char = ;code = 32
char = D;code = 68
char = ;code = 32
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char = n;code = 110
char = s;code = 115
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char = f;code = 102
char = f;code = 102
char = i;code = 105
char = c;code = 99
char = i;code = 105
char = e;code = 101
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char = c;code = 99
char = y;code = 121
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char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = o;code = 111
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char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
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char = t;code = 116
char = s;code = 115
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char = o;code = 111
char = n;code = 110
char = ;code = 32
char = m;code = 109
char = a;code = 97
char = i;code = 105
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char = t;code = 116
char = e;code = 101
char = n;code = 110
char = a;code = 97
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = h;code = 104
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = d;code = 100
char = i;code = 105
char = a;code = 97
char = l;code = 108
char = y;code = 121
char = s;code = 115
char = i;code = 105
char = s;code = 115
char = .;code = 46
result sql = Vitamin D insufficiency and bone fractures in patients on maintenance hemodialysis.

Vitamin D insufficiency and bone fractures in patients on maintenance hemodialysis.

char = <;code = 60
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char = B;code = 66
char = A;code = 65
char = C;code = 67
char = K;code = 75
char = G;code = 71
char = R;code = 82
char = O;code = 79
char = U;code = 85
char = N;code = 78
char = D;code = 68
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char = ;code = 32
char = <;code = 60
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char = i;code = 105
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char = i;code = 105
char = s;code = 115
char = ;code = 32
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char = l;code = 108
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char = c;code = 99
char = r;code = 114
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char = a;code = 97
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char = e;code = 101
char = d;code = 100
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char = n;code = 110
char = ;code = 32
char = p;code = 112
char = a;code = 97
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char = i;code = 105
char = e;code = 101
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char = w;code = 119
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char = s;code = 115
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = e;code = 101
char = ;code = 32
char = (;code = 40
char = C;code = 67
char = K;code = 75
char = D;code = 68
char = );code = 41
char = ;code = 32
char = c;code = 99
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char = m;code = 109
char = p;code = 112
char = a;code = 97
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char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = g;code = 103
char = e;code = 101
char = n;code = 110
char = e;code = 101
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = T;code = 84
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
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char = t;code = 116
char = h;code = 104
char = ;code = 32
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char = a;code = 97
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char = e;code = 101
char = d;code = 100
char = ;code = 32
char = b;code = 98
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = p;code = 112
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = t;code = 116
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char = o;code = 111
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char = e;code = 101
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char = n;code = 110
char = o;code = 111
char = t;code = 116
char = ;code = 32
char = w;code = 119
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char = l;code = 108
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char = e;code = 101
char = r;code = 114
char = s;code = 115
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char = o;code = 111
char = o;code = 111
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = V;code = 86
char = i;code = 105
char = t;code = 116
char = a;code = 97
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char = i;code = 105
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char = D;code = 68
char = ;code = 32
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char = e;code = 101
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char = c;code = 99
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char = s;code = 115
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char = a;code = 97
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char = e;code = 101
char = d;code = 100
char = ;code = 32
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char = s;code = 115
char = ;code = 32
char = a;code = 97
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char = ;code = 32
char = h;code = 104
char = i;code = 105
char = g;code = 103
char = h;code = 104
char = e;code = 101
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char = i;code = 105
char = n;code = 110
char = c;code = 99
char = i;code = 105
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = c;code = 99
char = e;code = 101
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
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char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
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char = ;code = 32
char = g;code = 103
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char = e;code = 101
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char = a;code = 97
char = l;code = 108
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char = p;code = 112
char = o;code = 111
char = p;code = 112
char = u;code = 117
char = l;code = 108
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = .;code = 46
char = ;code = 32
char = I;code = 73
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = u;code = 117
char = d;code = 100
char = y;code = 121
char = ,;code = 44
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char = ;code = 32
char = a;code = 97
char = i;code = 105
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char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = ;code = 32
char = b;code = 98
char = e;code = 101
char = t;code = 116
char = w;code = 119
char = e;code = 101
char = e;code = 101
char = n;code = 110
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char = f;code = 102
char = r;code = 114
char = a;code = 97
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char = u;code = 117
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char = ;code = 32
char = D;code = 68
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = u;code = 117
char = s;code = 115
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char = a;code = 97
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char = ;code = 32
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char = s;code = 115
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char = S;code = 83
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char = /;code = 47
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char = h;code = 104
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char = d;code = 100
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char = d;code = 100
char = ;code = 32
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char = d;code = 100
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char = f;code = 102
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char = d;code = 100
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char = m;code = 109
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char = f;code = 102
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char = a;code = 97
char = c;code = 99
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char = u;code = 117
char = r;code = 114
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char = .;code = 46
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char = i;code = 105
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = f;code = 102
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char = c;code = 99
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char = r;code = 114
char = e;code = 101
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char = w;code = 119
char = a;code = 97
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char = ;code = 32
char = o;code = 111
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char = t;code = 116
char = a;code = 97
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char = n;code = 110
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = o;code = 111
char = m;code = 109
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char = m;code = 109
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char = d;code = 100
char = i;code = 105
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char = a;code = 97
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char = g;code = 103
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char = n;code = 110
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char = i;code = 105
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char = w;code = 119
char = s;code = 115
char = .;code = 46
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char = R;code = 82
char = o;code = 111
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char = n;code = 110
char = e;code = 101
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char = l;code = 108
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char = e;code = 101
char = c;code = 99
char = o;code = 111
char = r;code = 114
char = d;code = 100
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = S;code = 83
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
char = ;code = 32
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = a;code = 97
char = c;code = 99
char = t;code = 116
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char = P;code = 80
char = T;code = 84
char = H;code = 72
char = ;code = 32
char = (;code = 40
char = i;code = 105
char = P;code = 80
char = T;code = 84
char = H;code = 72
char = );code = 41
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = 2;code = 50
char = 5;code = 53
char = (;code = 40
char = O;code = 79
char = H;code = 72
char = );code = 41
char = ;code = 32
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = D;code = 68
char = (;code = 40
char = 3;code = 51
char = );code = 41
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = m;code = 109
char = e;code = 101
char = a;code = 97
char = s;code = 115
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = .;code = 46
char = ;code = 32
char = A;code = 65
char = l;code = 108
char = l;code = 108
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = s;code = 115
char = ;code = 32
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = e;code = 101
char = r;code = 114
char = w;code = 119
char = e;code = 101
char = n;code = 110
char = t;code = 116
char = ;code = 32
char = b;code = 98
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = d;code = 100
char = e;code = 101
char = n;code = 110
char = s;code = 115
char = i;code = 105
char = t;code = 116
char = o;code = 111
char = m;code = 109
char = e;code = 101
char = t;code = 116
char = r;code = 114
char = y;code = 121
char = ;code = 32
char = o;code = 111
char = f;code = 102
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
char = ;code = 32
char = l;code = 108
char = u;code = 117
char = m;code = 109
char = b;code = 98
char = a;code = 97
char = r;code = 114
char = ;code = 32
char = s;code = 115
char = p;code = 112
char = i;code = 105
char = n;code = 110
char = e;code = 101
char = ,;code = 44
char = ;code = 32
char = f;code = 102
char = e;code = 101
char = m;code = 109
char = o;code = 111
char = r;code = 114
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = n;code = 110
char = e;code = 101
char = c;code = 99
char = k;code = 107
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = d;code = 100
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = l;code = 108
char = ;code = 32
char = r;code = 114
char = a;code = 97
char = d;code = 100
char = i;code = 105
char = u;code = 117
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = B;code = 66
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = q;code = 113
char = u;code = 117
char = a;code = 97
char = l;code = 108
char = i;code = 105
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = w;code = 119
char = a;code = 97
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = l;code = 108
char = s;code = 115
char = o;code = 111
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = q;code = 113
char = u;code = 117
char = a;code = 97
char = n;code = 110
char = t;code = 116
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = b;code = 98
char = o;code = 111
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = u;code = 117
char = l;code = 108
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = s;code = 115
char = o;code = 111
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = ;code = 32
char = (;code = 40
char = Q;code = 81
char = U;code = 85
char = S;code = 83
char = );code = 41
char = .;code = 46
char = ;code = 32
char = D;code = 68
char = e;code = 101
char = s;code = 115
char = c;code = 99
char = r;code = 114
char = i;code = 105
char = p;code = 112
char = t;code = 116
char = i;code = 105
char = v;code = 118
char = e;code = 101
char = ;code = 32
char = s;code = 115
char = t;code = 116
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = l;code = 108
char = o;code = 111
char = g;code = 103
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = i;code = 105
char = c;code = 99
char = ;code = 32
char = r;code = 114
char = e;code = 101
char = g;code = 103
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = s;code = 115
char = i;code = 105
char = o;code = 111
char = n;code = 110
char = ;code = 32
char = m;code = 109
char = o;code = 111
char = d;code = 100
char = e;code = 101
char = l;code = 108
char = s;code = 115
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
char = ;code = 32
char = u;code = 117
char = s;code = 115
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = t;code = 116
char = o;code = 111
char = ;code = 32
char = a;code = 97
char = n;code = 110
char = a;code = 97
char = l;code = 108
char = y;code = 121
char = z;code = 122
char = e;code = 101
char = ;code = 32
char = f;code = 102
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = s;code = 115
char = ;code = 32
char = a;code = 97
char = s;code = 115
char = s;code = 115
char = o;code = 111
char = c;code = 99
char = i;code = 105
char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = .;code = 46
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = r;code = 114
char = /;code = 47
char = >;code = 62
char = <;code = 60
char = b;code = 98
char = >;code = 62
char = R;code = 82
char = E;code = 69
char = S;code = 83
char = U;code = 85
char = L;code = 76
char = T;code = 84
char = S;code = 83
char = ;code = 32
char = :;code = 58
char = ;code = 32
char = <;code = 60
char = /;code = 47
char = b;code = 98
char = >;code = 62
char = O;code = 79
char = n;code = 110
char = e;code = 101
char = ;code = 32
char = h;code = 104
char = u;code = 117
char = n;code = 110
char = d;code = 100
char = r;code = 114
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = i;code = 105
char = r;code = 114
char = t;code = 116
char = y;code = 121
char = ;code = 32
char = p;code = 112
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = e;code = 101
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char = t;code = 116
char = s;code = 115
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char = e;code = 101
char = r;code = 114
char = e;code = 101
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char = i;code = 105
char = n;code = 110
char = c;code = 99
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char = u;code = 117
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char = e;code = 101
char = d;code = 100
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char = i;code = 105
char = n;code = 110
char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
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char = f;code = 102
char = i;code = 105
char = n;code = 110
char = a;code = 97
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char = ;code = 32
char = a;code = 97
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char = a;code = 97
char = l;code = 108
char = y;code = 121
char = s;code = 115
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char = s;code = 115
char = .;code = 46
char = ;code = 32
char = P;code = 80
char = a;code = 97
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char = i;code = 105
char = e;code = 101
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char = t;code = 116
char = s;code = 115
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char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
char = e;code = 101
char = s;code = 115
char = ;code = 32
char = (;code = 40
char = n;code = 110
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char = =;code = 61
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char = 2;code = 50
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char = ;code = 32
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char = a;code = 97
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char = ;code = 32
char = l;code = 108
char = o;code = 111
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = ;code = 32
char = 2;code = 50
char = 5;code = 53
char = (;code = 40
char = O;code = 79
char = H;code = 72
char = );code = 41
char = ;code = 32
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = m;code = 109
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char = n;code = 110
char = ;code = 32
char = D;code = 68
char = (;code = 40
char = 3;code = 51
char = );code = 41
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = v;code = 118
char = e;code = 101
char = l;code = 108
char = s;code = 115
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char = (;code = 40
char = 1;code = 49
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char = .;code = 46
char = 8;code = 56
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char = n;code = 110
char = m;code = 109
char = o;code = 111
char = l;code = 108
char = /;code = 47
char = l;code = 108
char = ;code = 32
char = (;code = 40
char = i;code = 105
char = n;code = 110
char = t;code = 116
char = e;code = 101
char = r;code = 114
char = q;code = 113
char = u;code = 117
char = a;code = 97
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char = t;code = 116
char = i;code = 105
char = l;code = 108
char = e;code = 101
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char = r;code = 114
char = a;code = 97
char = n;code = 110
char = g;code = 103
char = e;code = 101
char = ,;code = 44
char = ;code = 32
char = I;code = 73
char = Q;code = 81
char = R;code = 82
char = :;code = 58
char = ;code = 32
char = 2;code = 50
char = 7;code = 55
char = );code = 41
char = ;code = 32
char = v;code = 118
char = s;code = 115
char = .;code = 46
char = ;code = 32
char = 3;code = 51
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char = .;code = 46
char = 0;code = 48
char = ;code = 32
char = n;code = 110
char = m;code = 109
char = o;code = 111
char = l;code = 108
char = /;code = 47
char = l;code = 108
char = ;code = 32
char = (;code = 40
char = I;code = 73
char = Q;code = 81
char = R;code = 82
char = :;code = 58
char = ;code = 32
char = 2;code = 50
char = 8;code = 56
char = .;code = 46
char = 5;code = 53
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = P;code = 80
char = ;code = 32
char = =;code = 61
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char = 0;code = 48
char = .;code = 46
char = 0;code = 48
char = 2;code = 50
char = 9;code = 57
char = );code = 41
char = ,;code = 44
char = ;code = 32
char = w;code = 119
char = e;code = 101
char = r;code = 114
char = e;code = 101
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char = m;code = 109
char = o;code = 111
char = r;code = 114
char = e;code = 101
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char = l;code = 108
char = i;code = 105
char = k;code = 107
char = e;code = 101
char = l;code = 108
char = y;code = 121
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char = f;code = 102
char = e;code = 101
char = m;code = 109
char = a;code = 97
char = l;code = 108
char = e;code = 101
char = s;code = 115
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char = ;code = 32
char = h;code = 104
char = a;code = 97
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char = ;code = 32
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char = o;code = 111
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char = g;code = 103
char = e;code = 101
char = r;code = 114
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char = d;code = 100
char = u;code = 117
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
char = n;code = 110
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = e;code = 101
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char = d;code = 100
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char = s;code = 115
char = t;code = 116
char = a;code = 97
char = g;code = 103
char = e;code = 101
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char = i;code = 105
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char = s;code = 115
char = e;code = 101
char = a;code = 97
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char = e;code = 101
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char = ;code = 32
char = a;code = 97
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char = d;code = 100
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char = e;code = 101
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char = B;code = 66
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char = a;code = 97
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char = u;code = 117
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char = .;code = 46
char = ;code = 32
char = Q;code = 81
char = U;code = 85
char = S;code = 83
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char = p;code = 112
char = a;code = 97
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char = a;code = 97
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char = r;code = 114
char = e;code = 101
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char = o;code = 111
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char = a;code = 97
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char = f;code = 102
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char = a;code = 97
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char = r;code = 114
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char = y;code = 121
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char = e;code = 101
char = a;code = 97
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char = a;code = 97
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char = s;code = 115
char = e;code = 101
char = r;code = 114
char = u;code = 117
char = m;code = 109
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char = 2;code = 50
char = 5;code = 53
char = (;code = 40
char = O;code = 79
char = H;code = 72
char = );code = 41
char = ;code = 32
char = v;code = 118
char = i;code = 105
char = t;code = 116
char = a;code = 97
char = m;code = 109
char = i;code = 105
char = n;code = 110
char = ;code = 32
char = D;code = 68
char = (;code = 40
char = 3;code = 51
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char = ;code = 32
char = c;code = 99
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char = n;code = 110
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char = n;code = 110
char = t;code = 116
char = r;code = 114
char = a;code = 97
char = t;code = 116
char = i;code = 105
char = o;code = 111
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char = ,;code = 44
char = ;code = 32
char = B;code = 66
char = M;code = 77
char = D;code = 68
char = ;code = 32
char = a;code = 97
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char = ;code = 32
char = t;code = 116
char = h;code = 104
char = e;code = 101
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char = r;code = 114
char = a;code = 97
char = d;code = 100
char = i;code = 105
char = u;code = 117
char = s;code = 115
char = ,;code = 44
char = ;code = 32
char = i;code = 105
char = P;code = 80
char = T;code = 84
char = H;code = 72
char = ;code = 32
char = l;code = 108
char = e;code = 101
char = s;code = 115
char = s;code = 115
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char = t;code = 116
char = h;code = 104
char = a;code = 97
char = n;code = 110
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char = 1;code = 49
char = 0;code = 48
char = 0;code = 48
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char = p;code = 112
char = g;code = 103
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char = a;code = 97
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char = d;code = 100
char = ;code = 32
char = h;code = 104
char = i;code = 105
char = s;code = 115
char = t;code = 116
char = o;code = 111
char = r;code = 114
char = y;code = 121
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char = o;code = 111
char = f;code = 102
char = ;code = 32
char = f;code = 102
char = r;code = 114
char = a;code = 97
char = c;code = 99
char = t;code = 116
char = u;code = 117
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char = s;code = 115
char = s;code = 115
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char = a;code = 97
char = t;code = 116
char = e;code = 101
char = d;code = 100
char = ;code = 32
char = w;code = 119
char = i;code = 105
char = t;code = 116
char = h;code = 104
char = ;code = 32
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char = t;code = 116
char = h;code = 104
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char = d;code = 100
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char = ;code = 32
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char = d;code = 100
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char = i;code = 105
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char = i;code = 105
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char = i;code = 105
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char = ;code = 32
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char = c;code = 99
char = t;code = 116
char = u;code = 117
char = r;code = 114
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result sql = BACKGROUND : The incidence of fractures is substantially increased in patients with chronic kidney disease (CKD) compared to the general population. The factors associated with increased bone fracture in this population are not well understood. Vitamin D deficiency has been associated with decreased bone mass and higher incidence of fractures in the general population. In this study, we aimed to assess the association between fracture and vitamin D status and other factors potentially associated with fracture in patients on maintenance hemodialysis.

METHODS : One hundred and forty-four patients were assessed and interviewed about previous low-trauma fractures. Evidence of fracture was obtained from medical records and also through patient interviews. Routine laboratory results were collected from medical records. Serum intact PTH (iPTH) and 25(OH) vitamin D(3) were measured. All patients underwent bone densitometry of the lumbar spine, femoral neck and distal radius. Bone quality was also assessed with quantitative bone ultrasound (QUS). Descriptive statistics, logistic regression models were used to analyze factors associated with fractures.

RESULTS : One hundred and thirty patients were included in the final analysis. Patients with fractures (n = 21) had lower 25(OH) vitamin D(3) levels (15.8 nmol/l (interquartile range, IQR: 27) vs. 30.0 nmol/l (IQR: 28.5), P = 0.029), were more likely females, had longer duration of end-stage kidney disease, and lower bone mineral density (BMD) at the distal radius. QUS parameters were not associated with fractures. Multivariate analyses revealed that serum 25(OH) vitamin D(3) concentration, BMD at the radius, iPTH less than 100 pg/ml and history of fractures were independent predictors of new bone fracture after the initiation of dialysis therapy.

CONCLUSION : Increased bone fragility in dialysis patients is associated with vitamin D deficiency and relative hypoparathyroidism in addition to reduced BMD at the radius. Further studies are needed to determine whether patients with vitamin D deficiency benefit from vitamin D supplementation to reduce fracture risk.

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