Renal Function and Bone Loss in a Cohort of Afro-Caribbean Men

Area of Science:

• Nephrology
• Bone Metabolism
• Geriatric Medicine

Background:

• Kidney function impacts bone health, but data on men of African ancestry, who have higher chronic kidney disease prevalence and peak bone mass, is limited.
• Previous studies in Caucasian men show poor renal function correlates with bone loss and fractures.

Purpose of the Study:

• To investigate the association between estimated glomerular filtration rate (eGFR) and bone loss rates in healthy Afro-Caribbean men aged 40+.
• To determine if impaired kidney function affects baseline bone mineral density (BMD) or its rate of change.

Main Methods:

• A cohort of 1451 Afro-Caribbean men (aged 40+) underwent bone density scans (DXA, QCT) approximately 6 years apart.
• Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine.
• Impaired kidney function (IKF) was defined as eGFR < 60 ml/min/1.7 m².

Main Results:

• 8.6% of the cohort had impaired kidney function (IKF).
• IKF was not associated with baseline BMD.
• Men with IKF showed significantly faster rates of decline in areal BMD (total hip, femoral neck, trochanter) and cortical volumetric BMD compared to men with normal kidney function (p<0.05).
• No significant association was found between IKF and changes in trabecular volumetric BMD.

Conclusions:

• Poorer kidney function is independently associated with accelerated bone loss in otherwise healthy Afro-Caribbean men.
• This suggests impaired kidney function contributes to skeletal deterioration in this population, even without overt kidney disease.
• Findings underscore the importance of monitoring kidney function for bone health in aging Afro-Caribbean men.