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Updated: Aug 26, 2025
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Significant associations between bone mineral density and vascular calcification in patients with different stages of
Jana Uhlinova1,2, Anne Kuudeberg3, Kaja Metsküla4
1Department of Internal Medicine, Institute of Clinical Medicine, University of Tartu, Puusepa str. 8, 50406, Tartu, Estonia. jana.uhlinova@kliinikum.ee.
Insights
Vascular calcification (VC) in chronic kidney disease (CKD) patients is inversely related to bone mineral density (BMD). Impaired BMD is linked to heart valve lesions and peripheral VC, impacting CKD-MBD management.
Area of Science:
- Nephrology
- Endocrinology
- Radiology
Background:
- Chronic kidney disease-mineral and bone disorders (CKD-MBD) are linked to widespread vascular calcification (VC) and poor bone health.
- Understanding the interplay between VC and bone mineral density (BMD) is crucial for managing CKD patients.
Purpose of the Study:
- To investigate the relationship between vascular calcification (VC) and bone mineral density (BMD) in patients with chronic kidney disease (CKD).
Main Methods:
- A cross-sectional study involving CKD patients at various stages.
- Vascular calcification assessed using Kauppila score (abdominal aorta), ankle-brachial index (ABI; peripheral), and echocardiography (heart valves).
- Bone mineral density (BMD) measured using total body densitometry.
Main Results:
- Inverse relationships observed between abdominal aorta calcification (AAC), high ABI, and BMD.
- Femoral neck and total spine BMD were significant independent determinants of AAC.
- Femoral neck, L1-L4 spine, and rib BMD were significant for ABI.
- Valvular calcification was associated with femur, femoral neck, and total BMD.
Conclusions:
- Clinically significant inverse relationships exist between VC and BMD in CKD patients.
- BMD at specific sites and total BMD correlate with heart valve lesions and peripheral VC.
- Findings may inform early diagnosis, monitoring, and treatment strategies for CKD-MBD.
Introduction:
Chronic kidney disease-mineral and bone disorders (CKD-MBD) is characterised by generalised vascular calcification (VC) and impaired bone health. We aimed to investigate the relationship between VC and bone mineral density (BMD) in CKD patients.
Methods:
We performed a cross-sectional study of patients with different stages of CKD. For assessment of VC of abdominal aorta lateral lumbar X-rays (Kauppila score), the ankle-brachial index (ABI) and echocardiography were used. Total body densitometry provided BMD.
Results:
Ninety patients (41% male, median age 64 years (range 29-87)) were included, of whom 41.1% had a Kauppila score > 1. Evidence of peripheral VC as measured by ABI was detected in 23.3% of cases. Lesions of the heart valves were found in 46.7% of patients. There was a significant association between high ABI and lesions of the heart valves. In the multivariate regression model to analyse the independent determinants of abdominal aorta calcification (AAC) and ABI, the BMD of the femoral neck was identified as significant for both (p = 0.001, p = 0.001). The total spine BMD was found to be significant for AAC (p = 0.001), and the BMD of spine L1-L4 and the ribs were found to be significant for ABI (p = 0.01, p = 0.002 respectively). In factorial regression analysis, where BMD was independent determinant, valvular calcification was significant for BMD of femur, femoral neck and total BMD. Age and tALP were inversely correlated with the BMD of femur and femoral neck.
Conclusions:
Our work highlighted clinically important relationships between VC and bone mineral density (BMD) in CKD patients. We detected inverse relationships between AAC, high ABI and BMD. Secondly, BMD at certain bone sites (femur, femoral neck) and total BMD were associated with important lesions of heart valves. Thirdly, a significant association between a high ABI and lesions of the heart valves. We believe that the results of our study will help in the planning of future research and in current clinical practice for the early diagnosis, further monitoring and management of CKD-MBD. Additionally, these results may have treatment implications on use of different CKD-MBD medications.
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