Factors Associated With Lumbar and Femoral Bone Mineral Density in Kidney Transplants Candidates

Data on risk factors associated with low bone mineral density are limited in patients with end-stage renal disease. This study evaluated the factors deemed associated with lumbar and femoral Z and T scores.

Clinical and demographic data of 98 patients waiting for kidney transplantation were collected, as well as lumbar and femoral bone densitometries, before transplantation. Osteoporosis and osteopenia and factors associated with bone mineral density were assessed.

According to the femoral T score, 38.8% (95% confidence interval [CI], 29.1% to 48.4%), 44.9% (95% CI, 35.1% to 54.7%), and 16.3% (95% CI, 9.0% to 23.6%) of the patients had normal bone density, osteopenia, and osteoporosis, respectively. According to the lumbar T score, 54.1% (95% CI, 44.2% to 63.9%), 33.7% (95% CI, 24.3% to 44.0%), and 12.2% (95% CI, 5.8% to 18.7%) of the patients had normal density, osteopenia, and osteoporosis, respectively. Age, serum levels of creatinine and parathyroid hormone, and use of calcitriol and calcium carbonate were associated with femoral densitometry scores. Serum total protein level, Rh-negative status, and B blood type were associated with the lumbar scores.

Parathyroid hormone contributed to bone loss in our kidney transplant candidates, and B and Rh-negative blood types were associated with a higher risk of lumbar osteoporosis while total protein was negatively associated with the risk of bone loss. Calcitriol might improve femoral mineral density, but calcium carbonate was negatively associated with femoral bone density. Age and higher creatinine levels were associated with higher femoral bone densities.