Relationship of bone density with serum parathyroid hormone in hemodialysis patients; a single center study

Abstract

Introduction: The existence of a relationship between the level of serum parathyroid hormone (PTH) and bone density can be a warning sign in hemodialysis patients. Objectives: In the studies conducted so far, the relationship between these two factors has not been specifically investigated. Hence, this study was aimed to exclusively evaluate the levels of serum PTH hormone and bone density. Patients and Methods: In this cross sectional study, 85 eligible chronic hemodialysis patients aged over 18 years old who underwent hemodialysis a minimum of two times a week for at least 6 months were enrolled in the study. Serum intact PTH, 25 OH-vitamin D3, CBC, calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), albumin (Alb), and VBG were measured. Additionally, lumbar radiographic profile and densitometry tests were conducted for patients. Results: The mean age of patients was 52.9 years (20 to 86 years old). Of them, 43 patients were male (50.58%). There was a significant correlation between age and the decrease in bone density (P = 0.004). There was a significant relationship between different groups of bone density and serum vitamin D3 level (P < 0.05). Based on the results of Z standard, a significant difference between the mean levels of intact PTH in different groups of bone density was seen (P = 0.037). Conclusion: The prevalence of osteopenia and osteoporosis in hemodialysis patients is high. In addition, the decrease in bone density is associated with high levels of PTH. While this association is mainly associated with Z score, it is necessary to investigate the secondary causes of this condition. Please cite this paper as: Omidvar B, Ghorbani A, Tamadon MR, Sadeghian Broujeni Z, Bahadoram M, Dargahi M. Relationship of bone density with serum parathyroid hormone in hemodialysis patients; a single center study.

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

“…This study showed that most of ESRD patients had significantly low BMD, including osteopenia and osteoporosis, with a percentage of 83%, 71.1% and 71.1% at the total, hip and spine, respectively. See Fig 1. This is close to the findings of previous studies [14,15,21].…”

“…Low BMD was found to be associated with increased total duration of dialysis, higher serum PTH level, higher serum calcium level and decreased intake of elemental calcium supplement which confirms the findings of previous studies [ 9 , 14 , 22 – 24 ].…”

“…To examine the strength of the bones, there are qualitative (Bone Biopsy) and quantitative (densitometry) methods. DEXA scan is recognized as the best available method worldwide to assess bone density because of its high accuracy, short scan time and low radiation dose [ 9 , 14 ].…”

“…Prevalence of bone disorders, including osteoporosis, in hemodialysis patients is estimated to be between 33–66% [ 14 ] The tendency to fracture is inversely correlated with BMD, confirming the importance of BMD measurement [ 17 ]. According to the WHO, The diagnosis of osteoporosis is applied when the T score on Bone-Mineral Density measurement using DEXA scan is -2.5 or lower [ 15 , 18 ].…”

Renal bone disease in patients on hemodialysis: an observational study focusing on the variation of calcium metabolism

“…Omidvar B et al, study with significant P value as 272.75±122.58, 454.16±405.49, 652.26±735.41 (0.04). 22 In present study, authors have found 37.3% cases has diabetes, 93.3% cases has hypertension and 25.5% patients has ischemic heart disease. The study by Gomez AT et al, revealed the similar finding with 30.6% has diabetes, 17.9% has hypertension and 30.6% has ischemic heart diseases.…”