Izvorni znanstveni članak

https://doi.org/10.11613/BM.2013.042

Determinants of bone mineral density in patients on haemodialysis or peritoneal dialysis – a cross-sectional, longitudinal study

Mads Nybo ; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Denmark 2Department of Nephrology, Aarhus University Hospital, Skejby, Denmark
Bente Jespersen ; Department of Nephrology, Aarhus University Hospital, Skejby, Denmark
Michael Aarup ; Department of Nephrology, Odense University Hospital, Denmark
Charlotte Ejersted ; Department of Endocrinology, Odense University Hospital, Denmark
Anne Pernille Hermann ; Department of Endocrinology, Odense University Hospital, Denmark
Kim Brixen ; Department of Endocrinology, Odense University Hospital, Denmark

Sažetak

Introduction: The aim of the study was to identify biomarkers of alteration in bone mineral density (BMD) in patients on haemodialysis (HD) and peritoneal dialysis (PD).
Materials and methods: In a cross-sectional, longitudinal study dual-energy X-ray absorptiometry scans were performed in 146 HD-patients and 28 PD-patients. Follow-up after 14 months (mean) was conducted in 73 patients. As potential biomarkers we investigated parathyroid hormone (PTH), 25-hydroxy vitamin-D, ionised calcium, albumin, phosphate, and total alkaline phosphatases (t-ALP).
Results: Both groups of dialysis patients had lower BMD in the femoral neck (BMDneck) (P < 0.001) and forearm (BMDforearm) (P < 0.001) compared to healthy controls, but comparable BMD in the lumbar spine (BMDspine). BMD did not differ between dialysis types, but patients ever-treated with glucocorticoids had significantly lower BMD, while patients with polycystic kidney disease had higher BMD. BMD correlated with body weight, actual age, age at initiation of dialysis, duration of dialysis and levels of PTH and t-ALP. However, t-ALP only remained associated with low BMDspine after adjusting for other factors (P = 0.001). In the follow-up study all patients had decreased BMD in all three locations, but only for the lumbar spine there was a significant association between BMD and the bone markers t-ALP (P = 0.009) and PTH (P = 0.013).
Conclusions: Both HD and PD patients have low BMD, and increased concentrations of t-ALP is associated BMDspine after adjustment, while PTH and t-ALP is associated with decrease in BMDspine over time. This substantiates the use of these biomarkers in both types of dialysis patients.

Ključne riječi

alkaline phosphatases; bone density; dialysis; parathyroid hormone

Hrčak ID:

109259

URI

https://hrcak.srce.hr/109259

Datum izdavanja:

15.10.2013.

Posjeta: 1.338 *