Predictors of bone mineral density in dialyzed and non-dialyzed patients with chronic kidney disease

In this study, we assessed predictors of bone mineral density (BMD) in chronic kidney disease (CKD) patients with declining renal function. Among the 106 patients enrolled, 26 were treated with peritoneal dialysis [PD: 15 women; age; 55.7 +/- 17.7 years; dialysis vintage: 16.6 months (range: 6.3 - 45.5 months)]; 60, with hemodialysis [HD: 26 women; age: 54.8 +/- 15.3 years; dialysis vintage: 36.9 months (range: 6.0 - 279.6 months)]; and 20 were in CKD stage 2 or 3 (11 women; age: 49.4 +/- 15.8 years). We measured BMD in the femoral neck. Anthropometric measurements assessing nutrition status and routine laboratory parameters were obtained. The femoral neck BMD was 0.842 +/- 0.137 g/ cm2 (PD patients), 0.813 +/- 0.204 g/cm2 (HD patients), and 0.988 +/- 0.197 g/cm2 (CKD patients). In a stepwise backward regression analysis with all patients included, sex, age, body mass index, serum albumin, creatinine, parathyroid hormone, blood pH, and dialysis treatment were significant predictors of BMD (corrected R2 for the model: 0.977), with blood pH being the most powerful predictor (beta = 0.872, p = 0.000). We expect better preservation of BMD in CKD patients more rigorously treated for acid-base imbalance.