Bone metabolism in dialysis patients assessed by biochemical markers and densitometry

ABSTRACT

A decrease in bone mineral density is common in patients with chronic renal failure. It is also a risk factor for fractures in this population. The aim of the study was to evaluate bone mineral density-BMD and some biochemical markers of bone metabolism in patients on chronic hemodialysis. The study was performed on 50 patients on chronic hemodialysis. Bone mineral density was measured using dual energy x-ray absorptiometry [DEXA] in the distal left forearm. Concentrations of iPTH and carboxy terminal propeptide of type I collagen [PICP] was measured by commercially available Kits. Mean T scores of the distal left forearm were -2.7 +/- 2.2 for men and -2.2 +/- 1.9 for women T scores in the range of osteopenia were present in 30% of patients, and in the osteoporosis range in 54% of patients. Patients with bone mass measurements in the osteoporosis range had significantly increased iPTH levels compared with patients with T scores in the osteopenic/normal range. There was statistically significant negative correlation between BMD T scores and iPTH [r=-0.63, P0.0032] and with PICP [r=-0.820, P=0.0001]. On the basis of our finding we conclude that bone loss is seen in patients on chronic hemodialysis. Bone turnover markers estimated in this population correlated well with BMD measurements at sites of pure cortical bone as the distal radius