Fusaro M, D'Arrigo G, Pitino A, et al. - In a large international cohort of hemodialysis patients, researchers ascertained if proton pump inhibitors (PPIs) use is associated with bone fractures (ie, hip fractures and fractures other than hip fractures). An observational prospective cohort of 27,097 hemodialysis patients from the DOPPS study was included, among whom 13,283 patients were treated with PPIs. In multiple Cox models, the incidence rate of bone and hip fractures was significantly higher in PPI treated than in untreated PPI patients, taking into account the competitive risk of mortality. These results were also accurate in various, cause-specific, hazards Cox models matching patients by prescription time. In hemodialysis patients, the use of PPIs necessitates caution and a careful assessment of risks/benefits ratio, according to the researchers.