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J parathyr dis. 2018;6(2): 50-56.
doi: 10.15171/jpd.2018.18
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Bone mineral density and bone metabolism biochemical markers in patients with chronic kidney disease at the hemodialysis treatment

Mohammad Reza Tamadon, Jamileh Moghimi*, Vahid Semnani

1 Department of Internal Medicine, Kowsar Hospital, Semnan University of Medical Sciences, Semnan, Iran
*Corresponding author: Jamileh Moghimi, moghimi_jam@yahoo.com

Abstract

Introduction: Chronic kidney disease (CKD) is associated with bone and mineral metabolism disorders.Objectives: This investigation studied the bone mineral density (BMD) and bone metabolism biochemical markers in patients with CKD at the hemodialysis treatment among a group of Iranian hemodialysis patients. We also sought to test the possible association of risk factors and biochemical parameters with BMD.Patients and Methods: In this cross sectional study, 77 patients with CKD stage 5D at the hemodialysis treatment. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the anteroposterior lumbar spine (LS) (L1-L4) and left proximal femur. Biochemical markers, including calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), serum specific alkaline phosphatase (ALP) and 25-hydroxy-vitamin D (25(OH)D) were measured to assess BMD loss.Results: Around two (2.6%) patients had normal levels of 25(OH) D (mean levels 17.67 ± 11.66 nmol/l). We found a reduction of BMD in comparison with age and gender-matched normal population values at the femoral neck (FN) (T-score = -1.92 ± 1.29), at the total hip (TH) (T-score = -1.79 ± 1.25) and at the lumbar spine (LS) (T-score = -1.55 ± 1.84). The prevalence of T-scores ≤ -2.5 SD was 28.6%, 35.1% and 13.0% according to LS, FN and three bone sites T scores respectively. BMD negatively correlated: with age at the proximal femur, with serum ALP at the lumbar spine and with age of menopause at the femoral neck.Conclusion: Patients with end-stage renal disease at the hemodialysis treatment had a high prevalence of osteoporosis in the general population. Bone mineral density at the all bone sites was below the expected average for gender and age.
Keywords: Chronic kidney disease, Bone mineral density, Hemodialysis, Osteoporosis, Parathyroid hormone, End-stage renal disease
Please cite this paper as: Tamadon MR, Moghimi J, Semnani V. Metabolic bone disease in end-stage renal disease patients under regular hemodialysis J Parathyr Dis. 2018;6(x):x-x. DOI: 10.15171/jpd.2018.x.Copyright © 2018 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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ePublished: 09 Oct 2017
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