Related Experiment Video
Updated: May 9, 2026
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Bone mineral density in patients with predialysis chronic kidney disease
H K Aggarwal1, Deepak Jain, Sachin Yadav
1Department of Medicine, Pt. B.D. Sharma University of Health Sciences, Rohtak, Haryana, India. hariaggarwal@rediffmail.com
Insights
Reduced bone mineral density (BMD) is common in Indian patients with chronic kidney disease (CKD) not on dialysis, worsening as kidney function declines. This impacts osteoporosis risk and fracture potential.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Limited data exists on bone mineral density (BMD) and associated factors in non-dialysis chronic kidney disease (CKD) patients, particularly in the Indian population.
- CKD progression is linked to significant alterations in mineral and bone metabolism.
Purpose of the Study:
- To investigate the prevalence of reduced BMD and its relationship with biochemical parameters in Indian CKD patients not on dialysis.
- To understand how declining glomerular filtration rate (GFR) affects bone health in this population.
Main Methods:
- A cross-sectional study involving 75 adult CKD patients not on dialysis, categorized into three groups based on GFR.
- Baseline measurements included serum creatinine, albumin, calcium, phosphate, alkaline phosphatase, intact parathyroid hormone (iPTH), and Vitamin D.
- Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DXA).
Main Results:
- Serum phosphate, alkaline phosphatase, and iPTH levels increased with CKD progression, while corrected calcium and Vitamin D levels decreased.
- Mean PTH levels significantly rose, and Vitamin D levels declined across CKD stages (p < 0.05).
- Both Z-scores and T-scores for BMD showed a significant positive correlation with GFR, and negative correlation with iPTH, and positive correlation with Vitamin D.
Conclusions:
- Reduced bone density is evident early in CKD, characterized by lower BMD, increased osteoporosis prevalence, and elevated fracture risk.
- Bone health deteriorates progressively with advancing stages of chronic kidney disease.
- Early detection and management of bone density loss are crucial in non-dialysis CKD patients.
Background:
There is limited data available especially in Indian Population about prevalence of reduced bone mineral density (BMD) and various factors associated with it in CKD patients not on dialysis.
Material:
This study included 75 adult patients. Patients were divided into three groups depending upon GFR. Serum creatinine, albumin, calcium, phosphate (PO4), alkaline phosphatase, iPTH and Vitamin D were measured at baseline. BMD was measured by dual energy X-ray absorptiometry.
Results:
There were 51 male and 24 female patients. The mean serum phosphate, alkaline phosphatase and iPTH levels increased steadily as CKD progressed. On the other hand, mean corrected serum calcium and Vitamin D levels decreased progressively in group A, B and C. The mean serum PTH values in group A, B and C were 137.16 ± 109.85, 265.02 ± 132.03 and 328.14 ± 119.23 pg/mL, respectively and there was significant increase in mean PTH level from group A to group C (p < 0.05). The mean level of vitamin D showed a trend of declination from group A to C (p < 0.05). Z-score for group A, group B and group C was 1.11 ± 2.39, 0.87 ± 2.66 and -0.92 ± 1.59, respectively. Similarly, T score for the three groups were 0.47 ± 2.34, -0.4 ± 2.00 and -1.524 ± 1.42. Both T-score and Z-score positively correlated with GFR. There was negative correlation between Z-score and iPTH, and positive correlation with Vitamin D.
Conclusion:
Reduced bone density was seen early in the course of CKD as estimated from reduced BMD levels, increased prevalence of osteoporosis and increased fracture risk and it worsened with the progression of CKD.
Related Concept Videos
01:24Chronic Kidney Disease II: Clinical Manifestations
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Chronic Kidney Disease I: Introduction
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:18Chronic Kidney Disease IV: Nursing Management