Bone mineral density and bone metabolism biochemical markers in patients with chronic kidney disease at the hemodialysis treatment

Abstract

Introduction: Chronic kidney disease (CKD) is associated with bone and mineral metabolism disorders. Objectives: This study investigated the bone mineral density (BMD) and bone metabolism biochemical markers in patients with CKD at the hemodialysis treatment among Iranian adults as well as the relationship between possible risk factors or biochemical markers with BMD. Patients and Methods:In this cross-sectional study, 77 patients with CKD stage 5D at the hemodialysis treatment were selected from September 2016 to February 2016. BMD was measured by dual-energy X-ray absorptiometry (DEXA) at the anteroposterior lumbar spine (LS) (L1-L4) and left proximal femur. Biochemical markers including calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), serum specific alkaline phosphatase (serum AP) and 25-hydroxy-vitamin D (25hD) were used for the prediction of BMD loss. Results: Two (2.6%) patients had normal levels of 25hD (mean levels 17.67 ± 11.66 µg/L). We found a reduction of BMD in comparison with age-and gender-matched normal population values at the femoral neck (FN) (T-score = -1.92 ± 1.29), at the total hip (TH) (T-score = -1.79 ± 1.25) and at the LS (T-score = -1.55 ± 1.84). The prevalence of T-scores ≤-2.5 SD was 28.6%, 35.1% and 13.0% according to the LS, FN and three bone sites T scores respectively. BMD negatively correlated with age at the proximal femur, with serum AP at the LS and with age of menopause at the FN. Conclusions:Patients with CKD at the hemodialysis treatment had a high prevalence of osteoporosis in the general population. BMD at the all bone sites was below the expected average for gender and age. Keywords: Bone mineral density, Chronic kidney disease, Hemodialysis, Biochemical markers, Osteoporosis Please cite this paper as: Tamadon MR, Moghimi J, Semnani V. Metabolic bone disease in end-stage renal disease patients under regular hemodialysis. J Parathyr Dis. 2018;6(2):50-56.