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Renal osteodystrophy in hemodialysis patients
1Second Department of Internal Medicine, Hiroshima University School of Medicine.
Hiroshima Journal of Medical Sciences
|September 1, 1995
Summary
Chronic hemodialysis patients experience greater bone loss, particularly women post-menopause. Age and dialysis duration are key factors, with specific biomarkers influencing bone density in males and females. Controlling these biomarkers can help prevent bone loss.
Area of Science:
- Nephrology
- Endocrinology
- Bone Metabolism
Background:
- Chronic kidney disease patients on hemodialysis often suffer from bone loss.
- Medications like phosphate binders and 1 alpha-OH D3 are used, but bone loss patterns require further investigation.
Purpose of the Study:
- To investigate bone loss patterns in hemodialysis patients.
- To identify clinical factors and biomarkers associated with bone loss in these patients.
Main Methods:
- Studied 88 hemodialysis patients and 60 controls.
- Measured bone mass indices: metacarpal index (MCI), sigma gray scale/diameter (sigma GS/D), and bone mineral content (BMC).
- Correlated bone mass indices with clinical factors: age, dialysis duration, serum phosphate (P), calcium (Ca), carboxy-terminal fragments of parathyroid hormone (C-PTH), osteocalcin (OC), alkaline phosphatase (ALP), and Ca x P.
Main Results:
- Hemodialysis patients exhibited greater bone loss than controls, accelerated post-menopause in women.
- Bone mass indices negatively correlated with dialysis duration, C-PTH, and OC in males.
- BMC in females negatively correlated with P, C-PTH, and Ca x P.
Conclusions:
- Age and hemodialysis duration are primary drivers of bone loss in both male and female patients.
- C-PTH and OC are significant for skeletal bone loss in males; P, C-PTH, and Ca x P for trabecular bone loss in females.
- Controlling C-PTH, OC, P, and Ca x P levels is recommended to prevent bone loss in hemodialysis patients.