Background: Bone metabolism is affected in hemodialysed patients (HD) and PTH plays central role. Additionally leptin which is increased in renal failure may be linked with bone metabolism. We investigated the BMD and bone metabolism in comparison with serum PTH, 25OHD3 and leptin in HD patients.
Methods: We measured in 37 HD patients bone alkaline phosphatase (bSAP), NTx, PTH, 25OHD3 and leptin. We evaluated BMI and BMD in lumbar spine (LS) and in femoral neck (FN) by DXA. Correlation coefficients were calculated by simple regression analysis.
Results: 1. Osteopenia had 32.1% in LS and 50% in FN and osteoporosis had 14.3 and 21.4% respectively. LS or FN Z score had no correlation with HD duration.
2. Bone markers, PTH, phosphorus and leptin were increased.
3. 25OHD3 was low and had no correlation with NTx, bSAP or PTH.
4. PTH correlated with bone markers and Z score in LS and FN.
5. Leptin as expected, was strongly correlated with BMI. In contrast leptin had no correlation with bone markers or Z score.
Conclusions: In hemodialysed patients bone metabolism is increased in relation with the increased PTH resulting to low bone density which is independent of high serum leptin or 25OHD3 deficiency. Additionally the duration of hemodialysis does not seem to affect bone density.
25 - 29 Apr 2009
European Society of Endocrinology