Osteoporosis and Impaired Trabecular Bone Score in Hemodialysis Patients

Area of Science:

• Nephrology
• Endocrinology
• Bone Metabolism

Background:

• Dialysis patients frequently develop chronic kidney disease-mineral and bone disorder.
• Other bone diseases, like osteoporosis, are understudied in this population.
• Bone microarchitecture assessment is crucial for understanding fracture risk.

Purpose of the Study:

• To evaluate the prevalence of osteoporosis in hemodialysis patients.
• To assess bone microarchitecture using Trabecular Bone Score (TBS) in this cohort.
• To investigate the relationship between TBS and bone densitometry parameters.

Main Methods:

• 59 hemodialysis patients (mean age 67.6 years, 43 males) were included.
• Bone mineral density was assessed using Lunar Prodigy densitometry.
• Trabecular Bone Score (TBS) was calculated using specialized software (TBS 2.1.2).

Main Results:

• Osteoporosis was diagnosed in 34% of patients; 80% exhibited high bone turnover.
• Secondary hyperparathyroidism (PTH > 300 ng/l) was present in 69% of patients.
• A significantly decreased TBS was observed in 47.5% of the study population.
• TBS strongly correlated with T- and Z-scores of the lumbar spine and proximal femur.
• Significant differences in TBS were noted across normal, osteopenic, and osteoporotic bone density groups.

Conclusions:

• Approximately one-third of hemodialysis patients have osteoporosis.
• Normal TBS, indicative of good bone microarchitecture, was found in only 25% of patients.
• TBS is a valuable tool, correlating with densitometric measures and differentiating bone status in dialysis patients.