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A comparative study of atherosclerosis and osteopenia in elderly and young hemodialysis patients
1Nagoya University School of Medicine, Japan.
Insights
Aging accelerates atherosclerosis and osteopenia in hemodialysis patients. Elderly males show increased atherosclerosis, while elderly females exhibit more severe osteopenia, highlighting age and sex-specific risks in this population.
Area of Science:
- Nephrology
- Geriatrics
- Cardiovascular Medicine
Background:
- Hemodialysis patients often experience accelerated aging, leading to comorbidities like atherosclerosis and osteopenia.
- Aging significantly impacts cardiovascular health and bone metabolism, particularly in patients with chronic kidney disease.
Purpose of the Study:
- To investigate the effects of aging on atherosclerosis and osteopenia in hemodialysis patients.
- To compare cardiovascular and bone health markers between elderly and younger hemodialysis patients.
Main Methods:
- Eighty hemodialysis patients were divided into old (≥65 years) and young (<65 years) groups.
- Evaluated atherosclerosis using aortic pulse wave velocity (PWV) and aortic calcification grading.
- Assessed osteopenia via bone mineral content/bone width (BMC/W) and incidence of osteopenia.
Main Results:
- Elderly hemodialysis patients showed significantly higher aortic PWV and aortic calcification compared to controls.
- Elderly female patients had lower bone mineral content/bone width (BMC/W) and a higher incidence of osteopenia.
- Elderly males exhibited higher aortic calcification and lower serum Pi, [Ca] x [Pi], and PTH; elderly females had lower BMC/W.
Conclusions:
- Elderly male hemodialysis patients are more susceptible to atherosclerosis.
- Elderly female hemodialysis patients are more prone to developing advanced osteopenia.
- Aging exacerbates atherosclerosis and osteopenia in hemodialysis patients, with distinct sex-based vulnerabilities.
Abstract:
The effects of aging on atherosclerosis and osteopenia in hemodialysis patients were investigated. Eighty patients on maintenance hemodialysis were subdivided according to age into old (greater than or equal to 65 years old, N = 40) and young (less than 65 years old, N = 40). Biochemical, radiologic, and biophysical studies were performed in each patient to assess the degree of atherosclerosis and osteopenia. Compared to age-matched controls, patients in the old group exhibited a significantly higher aortic pulse wave velocity (PWV), and old female patients had a significantly lower bone mineral content/bone width (BMC/W). Elderly patients also had a significantly higher aortic PWV and higher grade of aortic calcification as assessed radiologically; in contrast, the BMC/W was lower. Concerning sex differences, elderly male patients had the highest average grade of aortic calcification, the lowest serum Pi, [Ca] x [Pi], and immunoreactive parathyroid hormone concentrations, while elderly female patients had the lowest BMC/W and highest incidence of osteopenia. These observations suggest that elderly male hemodialysis patients are more prone to develop atherosclerosis and elderly female hemodialysis patients to develop advanced osteopenia.