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Factors affecting bone mineral density in hemodialysis patients with diabetic nephropathy
Hiroshi Kaji1, Saburo Hattori, Kenichi Sekita
1Division of Endocrinology/Metabolism, Neurology and Hematology/Oncology, Department of Clinical Molecular Medicine, Kobe Graduate University School of Medicine, Kobe 650-0017, Japan.
Insights
Bone mineral density (BMD) in hemodialysis (HD) patients with diabetes mellitus (DM) was comparable to those with chronic glomerulonephritis (CGN). Factors influencing BMD, however, differed between the two groups.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Bone mineral density (BMD) in hemodialysis (HD) patients with diabetes mellitus (DM) remains unclear.
- This study compares BMD between HD patients with DM and chronic glomerulonephritis (CGN).
Purpose of the Study:
- To compare forearm BMD between HD patients with DM and CGN.
- To identify factors affecting BMD in these patient groups.
Main Methods:
- Cross-sectional study of 139 chronic HD patients.
- Forearm BMD (1/3-radius and ultradistal) measured using dual-energy x-ray absorptiometry.
Main Results:
- Forearm BMD was comparable between DM and CGN patients.
- In DM patients, BMI, creatinine, and beta2-microglobulin (betaMG) affected BMD.
- In CGN patients, HD duration, height, uric acid, triglyceride, and total cholesterol affected BMD.
Conclusions:
- Forearm BMD is similar in HD patients with DM and CGN.
- Factors influencing BMD differ significantly between DM and CGN patients on HD.
Background:
It remains undetermined whether bone mineral density (BMD) of hemodialysis (HD) patients with diabetes mellitus (DM) is reduced or not. The present study was performed to compare BMD between HD patients with DM and chronic glomerulonephritis (CGN). We analyzed the factors which affected BMD of 139 patients with chronic HD enrolled in this cross-sectional study.
Methods:
BMD of forearm [1/3-radius (R) and ultradistal (UD)-R] were measured by dual-energy x-ray absorptiometry.
Results:
1/3R-BMD and UDR-BMD of DM patients were comparable to those of CGN patients. In DM patients, body mass index (BMI) was positively correlated with UDR-BMD, serum levels of PTH and creatinine were negatively correlated with 1/3R-BMD, and serum level of beta2-microglobulin (betaMG) was positively correlated with UDR-BMD. In CGN patients, duration of HD and height were negatively correlated with 1/3R- and UDR-BMD, serum levels of uric acid and triglyceride were positively correlated with 1/3R- and UDR-BMD, and serum level of total cholesterol was positively correlated with UDR-BMD. In stepwise regression analysis, BMI and serum levels of creatinine and betaMG were selected for UDR-BMD in DM patients, although serum PTH level was selected for 1/3R-BMD.
Conclusion:
BMD at forearm was comparable between DM and CGN in HD patients. The factors affecting BMD seemed to be different between DM and CGN.