Document Detail

Relationship between bone mineral density and biochemical markers of bone turnover in hemodialysis patients.
MedLine Citation:
PMID:  18029324     Owner:  NLM     Status:  MEDLINE    
End-stage renal disease is closely associated with changes in bone and mineral metabolism. In recent times, osteoporosis has become important among hemodialysis (HD) patients. In this study, the investigators sought to evaluate the relationship between bone mineral density (BMD) and biochemical markers of bone turnover among HD patients. A total of 70 uremic patients on a maintenance HD program for at least 1 y were enrolled in the study. All patients were treated with conventional bicarbonated HD for 5 h through the use of low-flux hollow-fiber dialyzers. Bone densitometry was measured by dual energy x-ray absorptiometry in the lumbar spine (LS) and the femoral neck (FN). BMD was classified according to World Health Organization criteria on the basis of BMD T scores. Biochemical bone turnover markers such as calcium, phosphorus, ionized calcium, intact parathyroid hormone, alkaline phosphatase, plasma bicarbonate, blood pH, serum albumin, and hematocrit levels were measured before the HD session in the morning. Male patients (n=37; 52.9%; mean age, 46.2+/-17.0 y) were assigned to a single study group, and female patients (n=33; 47.1%; mean age, 44.0+/-13.1 y) to another. Mean duration of HD treatment was 33.7+/-28.5 mo in females and 33.0+/-26.0 mo in males. Among all patients, BMD T scores in the osteopenia/osteoporosis range were observed at the LS in 58 patients (82.8%) and at the FN in 45 patients (64.3%). According to BMD measurements in FN T score, 10% of patients (n=7) were osteoporotic, 54.3% (n=38), osteopenic, and 35.7% (n=25), normal. On the other hand, in LS T score, the results were 47.1% (n=33) osteoporotic, 35.7% (n=25), osteopenic, and 17.1% (n=12), normal. No statistically significant association was found in osteopenia/osteoporosis between sexes according to FN and LS T score (P=.542, P=.267, respectively). No significant relationship was noted between BMD and biochemical markers of bone turnover. A positive correlation was found between FN T scores of BMD and age (r=.413, P=.000). BMD T scores within the range of scores for osteopenia/osteoporosis were observed in 78.5% of patients at the LS and in 58.5% of patients at the FN. The investigators concluded that no correlation could be found between markers of bone turnover and bone mass measurements in both skeletal regions. LS T score results were worse than FN T score results. Elevated alkaline phosphastase levels combined with high intact parathyroid hormone levels are predictive of renal osteodystrophy but not of adynamic bone disease/osteoporosis.
Dede Sit; Ali Kemal Kadiroglu; Hasan Kayabasi; A Engin Atay; Zulfukar Yilmaz; M Emin Yilmaz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in therapy     Volume:  24     ISSN:  0741-238X     ISO Abbreviation:  Adv Ther     Publication Date:    2007 Sep-Oct
Date Detail:
Created Date:  2007-11-21     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8611864     Medline TA:  Adv Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  987-95     Citation Subset:  T    
Department of Nephrology, Dicle University Medical Faculty, Diyarbakir, Turkey.
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MeSH Terms
Absorptiometry, Photon
Biological Markers / blood
Bone Density*
Bone Diseases, Metabolic / blood*,  etiology,  physiopathology
Kidney Failure, Chronic / blood*,  complications,  therapy
Middle Aged
Osteoporosis / blood*,  etiology,  physiopathology
Renal Dialysis / adverse effects*
Uremia / blood,  complications,  therapy
Reg. No./Substance:
0/Biological Markers

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