Bone Mineral Density and Parathyroid Function in Patients on Maintenance Hemodialysis

Overview

Journal Int Urol Nephrol

Publisher Springer

Specialty Nephrology

Date 2010 Jan 22

PMID 20091221

Citations 5

Authors

Cs Ambrus

Cs Almasi

K Berta

Gy Deak

A Marton

M Zs Molnar

Zs Nemeth

Cs Horvath

P Lakatos

M Szathmari

I Mucsi

Affiliations

Soon will be listed here.

Abstract

Background: The relationship between parathyroid function, an important determinant of bone turnover, and bone mineral density (BMD) in patients with chronic kidney disease is not fully understood. We wanted to analyze the association between BMD and parathyroid function in hemodialysis patients in details.

Methods: In a cross-sectional design, data from 270 patients (age 55 ± 15 years, 60% men, all Caucasian) on maintenance hemodialysis were analyzed. All patients underwent dual energy X-ray absorptiometry of the lumbar spine (LS), femoral neck (FN) and distal radius (DR). In addition to routine laboratory tests, blood samples were collected for iPTH, serum markers of bone metabolism (alkaline phosphatase, type I collagen crosslinked-C-telopeptide) and 25OH vitamin D.

Results: Based on Z-scores, bone mineral density was moderately reduced only at the femoral neck in the total cohort. The average Z-score of the "low PTH" group (iPTH < 100 pg/ml) was not different from the Z-score of patients with iPTH in the "target range" (100-300 pg/ml) at any measurement site. While iPTH was negatively correlated with BMD at all measurement sites in patients with iPTH > 100 pg/ml (rho = -0.255, -0.278 and -0.251 for LS, FN and DR, respectively, P < 0.001 for all), BMD was independent of iPTH in patients with iPTH < 100 pg/ml. Furthermore, iPTH was not associated with serum markers of bone metabolism, but these markers were negatively correlated with BMD in the "low PTH" group.

Conclusions: Low PTH levels are not associated with low BMD in patients with end-stage kidney disease. Furthermore, bone metabolism seems to be independent of iPTH in patients with relative hypoparathyroidism likely reflecting skeletal resistance to PTH.

Citing Articles

Bone mineral density in Palestinian patients with end-stage renal disease and the related clinical and biochemical factors: Cross-sectional study.

Nazzal Z, Khader S, Zawyani H, Abdallah M, Sawalmeh O, Hamdan Z PLoS One. 2020; 15(11):e0241201.

PMID: 33180791 PMC: 7661051. DOI: 10.1371/journal.pone.0241201.

Total and bone-specific alkaline phosphatase are associated with bone mineral density over time in end-stage renal disease patients starting dialysis.

Bergman A, Qureshi A, Haarhaus M, Lindholm B, Barany P, Heimburger O J Nephrol. 2016; 30(2):255-262.

PMID: 26994005 DOI: 10.1007/s40620-016-0292-7.

Relationship between mild-to-moderate chronic kidney disease and decreased bone mineral density in Chinese adult population.

Kong X, Tang L, Ma X, Liu W, Wang Z, Cui M Int Urol Nephrol. 2015; 47(9):1547-53.

PMID: 26265108 DOI: 10.1007/s11255-015-1082-1.

Administered paricalcitol dose and survival in hemodialysis patients: a marginal structural model analysis.

Miller J, Molnar M, Kovesdy C, Zaritsky J, Streja E, Salusky I Pharmacoepidemiol Drug Saf. 2012; 21(11):1232-9.

PMID: 22996597 PMC: 4304639. DOI: 10.1002/pds.3349.

Vitamin D insufficiency and bone fractures in patients on maintenance hemodialysis.

Ambrus C, Almasi C, Berta K, Deak G, Marton A, Molnar M Int Urol Nephrol. 2010; 43(2):475-82.

PMID: 20237846 DOI: 10.1007/s11255-010-9723-x.

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