Bone mineral density in Palestinian patients with end-stage renal disease and the related clinical and biochemical factors: Cross-sectional study

Abstract

Introduction End-Stage Renal Disease (ESRD) is the ultimate result of chronic kidney disease (CKD). In Palestine, the prevalence of ESRD was 240.3 PMP which is comparable with the nearby countries. Accelerated bone loss among ESRD patients is attributed to abnormal bone turn over that leads to osteoporosis and osteopenia. The risk of fractures is increased four-fold in men and women on hemodialysis, which explains the importance of assessing the bone mineral density among these population. The goals of this study were to find the prevalence of osteoporosis in ESRD patients as determined by bone mineral density (BMD) at different sites and to determine whether BMD correlates with many other clinical parameters. Methods A cross-sectional study of 194 ESRD patients were recruited from the dialysis unit in An-Najah National University Hospital, Nablus, Palestine. The patients were on regular hemodialysis or peritoneal dialysis. BMD was measured at the lumbar spine and the hip using the dual-energy X-Ray absorptiometry (DEXA) and the value is expressed as T-score. The data were analyzed using SPSS, version 26. The relationship between BMD and the clinical and biochemical parameters among the ESRD patients was assessed. Results We found that 42.8% of ESRD patient had osteoporosis and 40.2% had osteopenia. There were significantly higher proportions of osteoporosis and osteopenia among patients >60 years of age (p<0.005). Patients with osteoporosis and osteopenia had significantly higher serum levels of PTH (792.9 and 469.7) (p<0.05). BMD decreases as the duration of dialysis (39.0 months Vs. 56.8 months), (p<0.05). We found no significant difference between patients on hemodialysis or peritoneal dialysis. Conclusion This study showed that Palestinian patients with ESRD have low BMD at the hip and spine. The observed high serum level of PTH was associated with low BMD. Those patients should be closely monitored especially those with more than one risk factor. Moreover, more attention should be paid for these category of patients to decrease the incidence of falling down and the resulting fractures that might lead to mortality and morbidity.

Prevalence and Risk Factors of Osteoporosis in Saudi End-Stage Renal Disease Patients on Hemodialysis

“…Conversely, it has been reported elsewhere that the LS (rather than the FN or the hip) is the most affected osteoporosis site in CKD and ESRD patients. [ 4 , 5 , 12 ]…”

“…In Palestine, in a study conducted on 194 patients to assess the prevalence of osteoporosis in ESRD patients, the overall prevalence of osteoporosis was 43%; its prevalence was 32% and 34% in the hip and lumbar spine (LS), respectively. [ 5 ]…”

LncRNA ROR/miR-145-5p axis modulates the osteoblasts proliferation and apoptosis in osteoporosis

“…The dual-energy X-Ray absorptiometry (DEXA) method was applied for the detection of bone mineral density (BMD). The diagnosis of OP patients was based on the femoral neck and lumbar spine T score (less than −2.5), when the T score of the femoral neck and/or lumbar spine was less than −2.5, OP was finally diagnosed [ 19 ]. All participants have a certain level of education and can cooperate with the completion of the research.…”

Kidney Transplantation, Immunosuppression and the Risk of Fracture: Clinical and Economic Implications

“…Chronic kidney disease-mineral and bone disorders (CKD-MBD) affect many patients who progress to chronic kidney failure and contribute to increased morbidity and even mortality. 1 , 2 , 3 CKD-MBD results in clinically evident osteoporosis in up to 66% of patients with kidney failure, 4 , 5 contributing to long-bone fractures, vertebral compression fractures, and other complications. 3 , 6 , 7 CKD-MBD is the outcome of chronic alternations in calcium or phosphorus metabolism, leading to hyperparathyroidism, alterations in the activity of fibroblastic growth factor-23, and impaired osteoblastic activity.…”

“… 3 , 6 , 7 CKD-MBD is the outcome of chronic alternations in calcium or phosphorus metabolism, leading to hyperparathyroidism, alterations in the activity of fibroblastic growth factor-23, and impaired osteoblastic activity. 3 , 4 , 5 , 6 , 7 …”