The Factors Effective on Bone Mineral Density in Peritoneal Dialysis Patients

Abstract

Bone mineral metabolism deteriorates gradually beginning from the early stages of chronic kidney disease (CKD). But, the KDIGO-2009 guideline could not provide high quality data regarding the biochemical tests related with bone mineral disorder in CKD. The aim of our study was to analyse the relationship between bone mineral densitometry and clinical and biochemical parameters in chronic peritoneal dialysis (PD) patients. Besides the demographic parameters, routine hematological and biochemical analysis results of PD patients followed up in our clinic were recorded. Bone mineral density (BMD) was measured at lumbar vertebrae and femur neck using DEXA machine. The mean lumbar T-and femur T-score were -1.03 +/- 1.20 (minimum:-3.73; maximum:+1.75) and -2.49 +/- 1.20 (minimum:-4.63; maximum:-0.51), respectively. Lumbar T score was significantly higher than femur T score (p<0.0001). Eight patients had BMD within normal limits; there was osteopenia in 16 and osteoporosis in 29 patients. While there was a negative correlation between femur T-score and age (r=-0.36, p=0.026), no correlation was detected between lumbar T-score and age (r=-0.17, p=0.21). With multivariate analysis of the factors related with femur T-score; age and body mass index (BMI) were the independent determinants while gender, parathyroid hormone levels and use of active vitamin D were not effective. Age was related negatively while BMI was related positively with BMD: BMD measurement at femur is more accurate than that at lumbar vertebrae in PD patients. BMD is low in most of the PD patients; and age and BMI are the major determinative factors.