Bone mineral density among patients undergoing continuous ambulatory peritoneal dialysis (CAPD)

Apart from the conventional risks, low bone mineral density (BMD) is one of the risk factors for bone fracture. Interestingly, the incidence of bone fracture is highest among patients with chronic renal failure, but there is little data comparing the BMD of patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with normal persons. The authors, therefore, compared the BMD between sex-, age- and bodyweight-matched CAPD patients and normal persons. The femoral neck, lumbar spine and total BMD were measured by dual energy X-ray absorptiometry in 62 CAPD patients and normal persons. In unadjusted analysis, femoral neck and total BMD in CAPD patients was significantly lower than normal controls in both men and women, while there was no significant difference at lumbar spine BMD between the two groups. The results were unchanged after adjusting for age, body weight and height (0.13 and 0.29 g/cm2, p < 0.001, for femoral and total BMD, respectively and 0.001 g/cm2, p = 0.96 for lumbar spine BMD). In conclusion, low BMD is already a major risk factor for hip fracture, and this risk is exacerbated by CAPD. BMD measurement should be incorporated into the routine care of CAPD patients in order to identify incipient osteoporosis, so that it may be treated to prevent fractures.