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Bone mineral density, vascular calcifications, and arterial stiffness in peritoneal dialysis patients

Teresa Adragao1, Patrícia Branco, Rita Birne

  • 1Nephrology Department, Santa Cruz Hospital, Lisbon, Portugal. tadragao@netcabo.pt

Peritoneal Dialysis International : Journal of the International Society for Peritoneal Dialysis
|November 5, 2008
PubMed

Insights

Lower bone mineral density (BMD) in the femoral neck, not the lumbar spine, correlates with increased arterial stiffness, vascular calcifications, and peripheral artery disease in peritoneal dialysis patients, suggesting a bone-cardiovascular link.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Bone disease and cardiovascular disease are common comorbidities in patients undergoing dialysis.
  • The relationship between bone mineral density (BMD) and vascular complications in this population requires further elucidation.

Purpose of the Study:

  • To investigate the association between BMD, evaluated by dual-energy X-ray absorptiometry (DXA), and markers of vascular disease in patients on peritoneal dialysis.

Main Methods:

  • Bone mineral density (BMD) was assessed using DXA.
  • Vascular calcifications were quantified using a vascular calcification score from plain X-rays.
  • Arterial stiffness was measured by pulse wave velocity (PWV) using the Complior device.

Main Results:

  • Lower BMD at the femoral neck, but not the lumbar spine, was significantly correlated with higher PWV (p = 0.037).
  • Reduced femoral neck BMD was also associated with a higher vascular calcification score (p = 0.013) and the presence of peripheral artery disease (p = 0.006).

Conclusions:

  • These findings support a connection between bone health and cardiovascular disease in patients on peritoneal dialysis.
  • Femoral neck BMD appears to be a more relevant indicator than lumbar spine BMD for vascular complications in this cohort.

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