engleski

Bone mineral densitometry in patients on hemodialysis : difference between genders and what to measure

Chronic kidney disease (CKD) and osteoporosis are important health problems. There is an interrelationship between osteoporosis and CKD. Bone densitometry is the "gold" standard in diagnosis of osteoporosis. Unfortunately, there are some problems with the interpretation of bone densitometry in CKD patients. The goal of this study was to determine bone mineral density (BMD) in CKD patients, to assess the difference between genders and different sites of bone densitometry correlation between BMD and laboratory parameters, and to assess the most optimal measuring site. We studied 134 hemodialysis patients (62 females, 72 males) mean age was 56.4±12.4 years, mean duration of hemodialysis was 54.4±60 months. BMD of the lumbar spine (posterior-anterior projection and lateral projection), hip (femoral neck, trochanter, intertrochanter, total femur, Ward's Triangle) and forearm (ultra-distal, mid, distal third portion and total forearm) was measured using dual X-ray absorptiometry (Hologic Delphi apparatus). Values were expressed as BMD, T-score and Z-score. Females had lower values of BMD in all measurement points. There were no significant differences between males and females in T- and Z-score forearm. Age was in a positive correlation with lumbar spine BMD in males and females. There was a negative correlation with neck and forearm BMD in both groups. Serum PTH was also in negative correlation with hip and forearm BMD in both groups. The best correlation of BMD in different sites was between forearm and neck. BMD data in CKD patients should be interpreted with caution and appendicular skeletal sites should be included in the evaluation.

bone mineral density ; dual-energy x-ray absorptiometry ; chronic kidney disease ; hemodialysis ; osteoporosis ;

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