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Cortical unlike trabecular bone loss is not associated with vascular calcification progression in CKD patients

Larissa R Costa1, Aluizio B Carvalho2, Amandha L Bittencourt2

  • 1Nephrology Division of Federal University of São Paulo, Rua Pedro de Toledo, 282 - Vila Clementino, São Paulo, SP, 04039-000, Brazil. larissadbr@hotmail.com.

BMC Nephrology
|April 8, 2020
PubMed

Insights

In chronic kidney disease (CKD) patients, bone loss occurs over time, but cortical bone loss is not linked to vascular calcification progression. Trabecular bone loss, however, is inversely associated with coronary artery calcium score changes.

Area of Science:

  • Nephrology
  • Orthopedics
  • Cardiology

Background:

  • Vascular calcification progression is linked to trabecular bone loss in chronic kidney disease (CKD) patients.
  • Limited data exist on the relationship between cortical bone loss and vascular calcification in CKD.
  • This study prospectively investigates cortical bone density changes and coronary artery calcification (CAC) progression in non-dialyzed CKD patients.

Purpose of the Study:

  • To evaluate the association between changes in cortical bone density and coronary artery calcification (CAC) progression.
  • To compare the roles of cortical and trabecular bone loss in vascular calcification.

Main Methods:

  • Prospective study analyzing vertebral tomographic images over 24 months.
  • Cortical bone layer automatically delineated using Image J; trabecular bone identified using Vitrea 2® software.
  • Bone density (BD) in Hounsfield Units (HU); coronary artery calcium (CAC) score in Agatston Units (AU).

Main Results:

  • 70 non-dialyzed CKD patients (mean age 57.8 years, 63% male) were followed.
  • No significant change in mean cortical or trabecular bone density over time.
  • 41% lost cortical bone (average -4.4%/year), 56% lost trabecular bone (average -3.15%/year).
  • Inverse correlation between trabecular bone loss and CAC progression (p=0.001); no correlation for cortical bone loss (p=0.34).

Conclusions:

  • CKD patients experience either cortical or trabecular bone loss, not always simultaneously.
  • Cortical bone loss is not associated with vascular calcification progression in these patients.
  • Trabecular bone loss, however, is significantly associated with vascular calcification progression.
Abstract

Keywords:
Chronic kidney diseaseCortical boneTrabecular boneVascular calcification

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