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Bone mineral densitometry in patients on hemodialysis: difference between genders and what to measure

Lidija Orlic1, Zeljka Crncevic, Drasko Pavlovic

  • 1Department of Nephrology, University Hospital Rijeka, Rijeka, Croatia. lidija.orlic@ri.t-com.hr

Renal Failure
|April 8, 2010
PubMed

Insights

Bone mineral density (BMD) in chronic kidney disease (CKD) patients is complex. Appendicular skeletal sites, like the forearm, should be included for accurate osteoporosis assessment in CKD patients.

Area of Science:

  • Nephrology
  • Endocrinology
  • Orthopedics

Background:

  • Chronic kidney disease (CKD) and osteoporosis are prevalent conditions with a known interrelationship.
  • Interpreting bone densitometry in CKD patients presents challenges.
  • Accurate assessment of bone mineral density (BMD) is crucial for managing osteoporosis in CKD.

Purpose of the Study:

  • To determine BMD in hemodialysis (HD) patients.
  • To compare BMD between genders and across different skeletal sites.
  • To assess correlations between BMD and laboratory parameters, identifying optimal measurement sites.

Main Methods:

  • Dual-energy X-ray absorptiometry (DXA) was used to measure BMD in 134 HD patients (62 female, 72 male).
  • Measurements included the lumbar spine, hip, and forearm at various sites.
  • Data analysis involved BMD, T-score, and Z-score evaluations, alongside correlation analyses with age and serum parathyroid hormone (PTH).

Main Results:

  • Females exhibited lower BMD values across all measured sites compared to males.
  • Age correlated positively with lumbar spine BMD and negatively with hip and forearm BMD in both genders.
  • Serum PTH showed a negative correlation with hip and forearm BMD; forearm and hip measurements demonstrated the strongest correlation.

Conclusions:

  • BMD interpretation in CKD patients requires caution.
  • Incorporating appendicular skeletal sites, such as the forearm, is recommended for comprehensive osteoporosis evaluation in CKD.
Abstract

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