Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

Valkovský, Ivo; R, Olšanská; Tvrdík, Josef; Martínek, Arnošt; Švagera, Zdeněk; M, Pernicová; Dedochova, Jarmila; Čermáková, Zuzana

doi:10.5507/bp.2013.087

Cited by 7 publications

(7 citation statements)

References 42 publications

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“…Several studies are consistent with our study showing that BMD decreased as age increased [14,17,18]. The effect of gender on bone mass in hemodialysis is controversial [19,20]. We found that BMD was significantly lower in women at the total body.…”

Section: Discussionsupporting

confidence: 91%

Mineral bone disorder and osteoporosis in hemodialysis patients

et al. 2020

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Background: Bone disease is common in patients undergoing hemodialysis. It is the result of bone turnover abnormalities and the decrease of bone mineral density (BMD). We aimed to determine the usefulness of serum bone turnover markers and BMD measurement by dual-energy x-ray absorptiometry (DXA) in hemodialysis patients. Methods: We conducted a cross-sectional study including 90 hemodialysis for more than 12 months. Bone mineral density was assessed by DXA. Peripheral blood samples were obtained from each patient before dialysis in a fasting state within a week of the DXA. Biochemical variables of calcium and phosphate were measured. One bone formation marker (bone-specific alkaline phosphatase (bAP), one bone resorption marker (carboxy-terminal telopeptides of type 1 collagen (CTX)) were measured. Total alkaline phosphatase (TAP), intact parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) which is a bone-derived hormone were also measured. Results: CTX values were 6.25 times higher than the normal limit of the assay. Bone alkaline phosphatase levels were less than 10 ng/mL in 28.8% of cases. 23% of patients have osteoporosis and 45% have osteopenia. Femoral BMD had negative correlations with age and PTH levels. FGF23 levels were significantly increased in patients with osteoporosis affecting the lumbar. The levels of bAP and CTX showed a positive correlation. Both circulating bAP and CTX levels showed also positive correlations with PTH levels. Fractures, observed in 12.2% of cases, were associated with low PTH values and the existence of osteoporosis. Conclusions: Our study showed that osteoporosis and fracture are common in dialysis patients. The reduced BMD was associated with advanced age and elevated levels of PTH. Markers of bone turnover and FGF23 may play a role in the diagnosis of bone disease in hemodialysis patients. DXA measurement is necessary for the monitoring for bone loss.

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Section: Discussionsupporting

confidence: 91%

Mineral bone disorder and osteoporosis in hemodialysis patients

et al. 2020

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“…This result is known to be common in hemodialysis patients with CKD (11,16). This finding suggests the possibility of a significant number of hemodialysis patients with osteomalacia in our study.…”

Section: Discussionsupporting

confidence: 61%

“…Hemodialysis patients with CKD are affected by bone disease associated with CKD and also share similar risk factors for osteoporosis with the general population (9,34,35). It should be noted that this bone disorder is multifactorial and complex and BMD alone may not be adequate to characterize the bone disease associated with CKD (9,11). In the present study, there was no relation between BMD T scores with Ca levels.…”

Section: Mean ± Sd T (Fn) T (Th) T (Ls)contrasting

confidence: 49%

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

Tamadon¹,

Moghimi²,

Semnani³

2017

J Parathyr Dis

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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.

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“…According to the NHANES study, the prevalence of osteoporosis in the general population with GF < 35 mL/min is 24% in women and 11% in men [39]. Recently, two Czech cross-sectional studies of similar Caucasian populations comprising subjects on haemodialysis or in the very early stages of hemodialysis treatment were published [40, 41]. The average TH T -score was -1.4 in both studies, while the average LS T -score was -0.5 and -0.3, respectively.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

Kratochvílová

Brunová

Wohl

et al. 2019

Journal of Diabetes Research

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Posttransplant osteoporosis, which evolves from preexisting bone pathologies, represents a serious complication with deteriorating consequences. The aim of our study was to evaluate epidemiological data on bone mineral density (BMD) in subjects with type 1 diabetes (T1DM) in advanced stages of diabetic nephropathy indicated for simultaneous pancreas-kidney transplantation (SPK). We retrospectively compiled biochemical and densitometrical data from 177 patients with T1DM at CKD (chronic kidney disease) stages G4-G5 (115 men, 62 women, median age 40 yr, diabetes duration 23 yr) enrolled on waiting list for SPK for the first time between the years 2011 and 2016. Median Z-scores were as follows: lumbar spine (LS): -0.8 [interquartile range -1.75 to 0.1]; total hip (TH): -1.2 [-1.75 to -0.6]; femoral neck (FN): -1.2 [-1.9 to -0.7]; and distal radius (DR): -0.8 [-1.4 to -0.1]. We noted a gender difference in LS, with worse results for men (-1.1 vs. -0.3) even after adjusting for BMI (body mass index) and glomerular filtration (p<0.001). Osteoporotic and osteopenic ranges (based on T-scores) for all major sites were 27.7% and 56.5%, respectively, with similar results across both genders. Women had a significantly higher proportion of normal BMD in LS than men (67.7 vs. 49.4%, p<0.05). Patients with T1DM at CKD stages G4-G5 exhibited serious BMD impairment despite their young age. Men surprisingly displayed lower Z-scores and higher percentages of pathological BMD values in LS than women did. The introduction of adequate preventive measures during the advanced stages of diabetic nephropathy to prevent bone loss is recommended.

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Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

Cited by 7 publications

References 42 publications

Mineral bone disorder and osteoporosis in hemodialysis patients

Mineral bone disorder and osteoporosis in hemodialysis patients

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

Retrospective Analysis of Bone Metabolism in Patients on Waiting List for Simultaneous Pancreas-Kidney Transplantation

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