#1725 Co-relation of bone mineral density (BMD) with static bone histomorphometric parameters in haemodialysis patients

Abstract

Abstract Background and Aims A mineral bone disorder of CKD (CKD MBD) is a complication with abnormal bone turnover, mineralization, volume, vascular calcification, and a spectrum of biochemical abnormalities. This clinical study was designed to determine the correlation between BMD (DEXA parameter) and static bone histomorphometry in hemodialysis patients. Method This was a cross-sectional study in patients undergoing maintenance hemodialysis aged 18-60 years. Bone biopsy was done from the iliac crest, fixed in alcohol, processed, and stained by RGB trichrome stain. Histomorphometric analysis was done by using NIH software (image J) and Adobe Photoshop software for image masking into black and white for volume calculation. Determination of BMD was performed by DEXA SCAN (Model HORIZON A). The detection sections included the central skeleton's three areas- anteroposterior lumbar (L1-L4) spine, proximal femur (femoral neck), and distal radius. Results A total of 46 patients on maintenance hemodialysis were included. Thirty-one (67.39%) were male, and the mean age was 34.43 ± 12.5 years. Amongst the study population, 60.87% (28) patients had osteopenia, 19.57%(9) patients had osteoporosis, and 19.57%(9) patients had normal BMD. Out of 46, four biopsies were inconclusive, 50% (21) had adynamic bone disease, 19.05%(8) had high turnover bone disease, 19.05%(8) had high mixed uremic osteodystrophy and 11.9%(5) patients had normal parameters. Among biochemical parameters, serum iPTH, ALP, and calcium had a significant association with bone turnover. BMD was significantly associated with age. However, it had no significant association with dialysis vintage, sex, or the type of renal osteodystrophy. Static bone histomorphometric parameters were not significantly associated with the T score. Conclusion PTH, ALP, and serum calcium were significantly associated with bone turnover. Adynamic bone disease was the most common renal osteodystrophy. BMD was not significantly associated with static bone histomorphometric parameters in our study.