Recently, since the lives of patients with chronic renal failure have prolonged considerably, the importance of prevention and treatment of metabolic bone disease which inevitably develops in this group, has become better appreciated.
The aim of this study was to evaluate the relation between bone mineral density (BMD) and specific markers of bone turnover in haemodialysis (HD) population.
A cross-sectional study involving 40 HD patients (27 M, mean age 54±14 yrs, and 13 F mean age 58±9 yrs) with no history of bone fractures was performed. Mean period on HD was 68±43 months. Serum levels of osteocalcin, beta-CrossLaps, iPTH and alkaline phosphatase (ALP) were measured before the dialysis session. BMD was estimated in the lumbar spine and in the hip using Dual Energy X-ray Absorptiometry (DXA). Low BMD was found in 67.5% (27/40) of haemodialysis patients. Diagnostic criteria of osteoporosis were fulfilled by 32.5% of subjects, more frequently in women (38.5%) than in men (29.6%). Osteopenia was observed in 35% of patients and was also more frequent in women (42.2%) than in men (29.6%).
Mean serum levels of ALP were significantly higher in women than in men (135.6±54 mIU/ml and 86±33 mIU/ml respectively).
We also observed a positive correlation between serum β-CrossLaps concentrations and PTH (in men P<0.001, r=0.66; in women P<0.006, r=0.71) and between serum osteocalcin levels and PTH (in men P<0.02, r=0.44; in women P<0.01, r=0.65).
ALP levels correlated positively with serum β-CrossLaps concentrations in women P<0.04, r=0.60.
The frequency of low bone mineral density in haemodialysis patients is high. Low bone density is more common in chronic dialysis women. The levels of bone turnover markers are mainly determined by the severity of hyperparathyreoidism.
01 - 05 Apr 2006
European Society of Endocrinology