Related Experiment Video
Updated: Jun 28, 2025
A Semi-Automated and Reproducible Biological-Based Method to Quantify Calcium Deposition In Vitro
Published on: June 2, 2022
Calcium-based phosphate binders and bone mineral density in patients undergoing hemodialysis: a retrospective cohort
Kazuhiko Kato1,2,3, Akio Nakashima4, Masamitsu Morishita3
1Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi Minato-Ku, Tokyo, 105-8461, Japan.
Insights
Calcium-based phosphate binders (CBPB) may help maintain bone mineral density (BMD) in hemodialysis patients. This study found CBPB use was associated with better BMD preservation over four years.
Area of Science:
- Nephrology
- Bone Metabolism
- Mineral and Bone Disorders
Background:
- Calcium supplements are common for osteoporosis but avoided in dialysis patients due to cardiovascular risks.
- This study investigates calcium-based phosphate binders (CBPB) and their impact on bone mineral density (BMD) in hemodialysis patients.
Purpose of the Study:
- To evaluate the effect of calcium-based phosphate binders (CBPB) on bone mineral density (BMD) trends in hemodialysis patients.
- To determine if CBPB administration influences BMD changes over a four-year period.
Main Methods:
- Retrospective cohort study of hemodialysis outpatients with BMD measurements.
- Exclusion of patients on anti-osteoporotic medications.
- Analysis of CBPB administration (presence and duration) and its association with BMD changes over four years.
Main Results:
- Patients on CBPB showed significantly better BMD maintenance compared to those not on CBPB.
- A minute decrease in femoral neck BMD was observed in the CBPB group versus a significant decrease in the non-CBPB group.
- Prolonged CBPB administration was linked to superior BMD preservation.
Conclusions:
- Calcium-based phosphate binder (CBPB) administration may be associated with maintaining bone mineral density (BMD) in hemodialysis patients.
- Further research is warranted to confirm these findings and explore the mechanisms involved.
Background:
Calcium supplements are commonly prescribed to prevent fractures in patients with osteoporosis. Nonetheless, they are generally eschewed in hemodialysis patients because they increase vascular calcification and induce cardiovascular disease. This retrospective cohort study aimed to investigate the effect of calcium-based phosphate binders (CBPB) on bone mineral density (BMD) in hemodialysis patients.
Methods:
Outpatients on dialysis who underwent BMD measurement from January to December 2017, whose data on BMD trends and CBPB administration were recorded over the next 4 years, were enrolled. Patients receiving anti-osteoporotic medications were excluded. The association between the presence and duration of CBPB administration and changes in BMD was evaluated.
Results:
The femoral neck's BMD decreased from 0.836 g/cm2 (0.702-0.952) to 0.764 g/cm2 (0.636-0.896) (P < 0.001) in the non-CBPB group (patients who never received CBPB over 4 years, n = 32). The CBPB group (n = 56) exhibited only a minute decrease from 0.833 g/cm2 (0.736-0.965) to 0.824 g/cm2 (0.706-0.939) (P = 0.004). Multivariate linear regression analysis revealed better BMD maintenance in the CBPB group [β-coefficient (95% CI): 0.033 (0.001-0.065); P = 0.046] than in the non-CBPB group. Additionally, the prolonged-CBPB administration group showed superior BMD preservation [β-coefficient (95% CI): 0.038 (0.001-0.076); P = 0.042].
Conclusion:
CBPB administration may be associated with BMD maintenance.
More Related Videos
Related Concept Videos
01:21Skeleton and Calcium Homeostasis
01:31Essential Minerals for Bone Health
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:25Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
01:40Bone Remodeling
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...