Comparison of bone mineral densityand biochemical factors in hemodialysis and peritoneal dialysis patients.

Abstract

The aim of the study is to assess and compare the level of bone mineral density (BMD) in the patients undergoing hemodialysis (HD) and peritoneal dialysis (PD) and to identify risk factors related to low BMD. Dual-energy X-ray absorptiometry (DEXA) scans were performed in 34 HD patients and 47 PD patients. Serum levels of albumin, calcium, phosphorus, alkaline phosphatase (ALP), intact parathyroid hormone (I-PTH), and 25-hydroxy (OH) vitamin D were recorded for the prediction of BMD loss. Among the biochemical parameters compared, only calcium levels differed between the group in such that HD patients had lower calcium compared with patients on PD (p=0.001). The overall prevalence of osteoporosis (OP) among all participants was 27%. There was a negative correlation between femur neck BMD and age (r=-554, p=0.007), and BMI (r=-555, p=0.007). Diabetic nephropathy was the only etiology associated with decreased BMD at the femoral site (p=0.027). There was a positive correlation between the serum albumin and BMD of lumbar spine (LS) (r=585, p=0.004). Bone mass of any site did not correlate with the dialysis type, duration of dialysis, and other biochemical markers like serum calcium, phosphorus, I-PTH, ALP, and 25 (OH) vitamin D. Prevalence of OP and osteopenia are high in dialysis patients, with no difference between patients on regular HD and PD. Bone mass loss is related to older age, higher BMI, and lower serum albumin level. DEXA measurement is necessary to monitor bone loss and timely treatment of OP in dialysis patients.