scholarly journals Evaluation of biochemical markers and bone mineral density in patients with chronic kidney disease stage 5D at the start of hemodialysis treatment

2015 ◽  
Vol 159 (1) ◽  
pp. 093-099 ◽  
Author(s):  
Ivo Valkovsky ◽  
Renata Olsanska ◽  
Josef Tvrdik ◽  
Arnost Martinek ◽  
Zdenek Svagera ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Mineral ◽  
Biochemical Markers ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Mineral Density ◽  
Hemodialysis Treatment

scholarly journals Association of Bone Mineral Density With Fractures Across the Spectrum of Chronic Kidney Disease: The Regina CKD-MBD Study

2019 ◽  
Vol 6 ◽  
pp. 205435811987053 ◽  
Author(s):  
Bhanu Prasad ◽  
Thomas Ferguson ◽  
Navdeep Tangri ◽  
Chee Yong Ng ◽  
Thomas L. Nickolas
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Biochemical Markers ◽  
Clinical Risk Factors ◽  
Mineral Density ◽  
Clinical Risk

Background: Recent studies have demonstrated that measurement of areal bone mineral density by dual-energy x-ray absorptiometry (DXA) predicts fractures in patients with chronic kidney disease (CKD). However, whether fracture risk prediction through bone mineral density (BMD) is enhanced due to the assessment of biochemical markers of chronic kidney disease and mineral and bone disease (CKD-MBD) or clinical risk factors is not clear. We hypothesized that in a select cohort of patients managed in a CKD clinic, that combining T-Scores with biochemical markers would optimize fracture discrimination than using DXA alone. Objective: To examine the relationships among BMD, biochemical markers of CKD-MBD, and fracture risk across Kidney Disease Improving Global Outcomes (KDIGO) glomerular filtration rate (GFR) categories G3a to G5. Design: Retrospective study. Setting: Patients were recruited from the multidisciplinary CKD clinic, Regina General Hospital, Canada. Patients: A total of 374 patients who received a DXA scan upon initial referral to Regina Multidisciplinary CKD Program from January 31, 2001 to January 31, 2010, were included in this study. The patients were followed for a total of 5 years. Methods: We conducted a retrospective review of 374 consecutive patients who underwent DXA imaging at the point of entry into our multidisciplinary CKD program. Areal BMD, T- and Z-Scores were obtained at the lumbar spine, total hip, mean of left and right femoral neck, and the one-third radius. We collected data on demographic, cross-sectional biochemical markers of mineral metabolism and fractures (identified through self-reported questionnaires, hospital electronic medical records, and physician billing records). We were able to gather data on 8/11 variables of Fracture Risk Assessment (FRAX) tool. Results: In our cohort, 14.3% of GFR categories G3a and G3b, 15.7% of GFR category G4, and 19.7% of GFR category G5 experienced a clinical fracture during the study period. On multivariate analysis, each decline of 1.0 SD in total hip BMD T-Score was associated with a significant increase in the risk of fracture (OR = 1.46, 95% confidence interval [CI], 1.12-1.89). Adding CKD-MBD markers and clinical risk factors did not further contribute to the model. Low BMD was the only independent risk factor for fracture in patients with CKD. Limitations: Self-reporting by patients and administrative records were used to identify fractures. We did not perform spine imaging to ascertain morphometric vertebral fractures. We were unable to gather all 11 variables of FRAX score and information on ethnicity. We were unable to capture site of fracture (hips, spine, etc) from billing records. Albumin excretion rates were not collected at baseline. Treatment of the underlying bone disease with pharmacotherapeutic agents may have attenuated patients’ fracture risk and thus underestimated the association between BMD and future fracture. Conclusions: Our findings confirm that BMD predicts fracture. The addition of cross-sectional CKD-MBD parameters and clinical risk factors to BMD did not add to fracture prediction. Prospective studies should investigate the utility of longitudinal biochemical markers on improving fracture risk assessment.

scholarly journals Mild Renal Dysfunction Is a Risk Factor for a Decrease in Bone Mineral Density and Vertebral Fractures in Japanese Postmenopausal Women

2010 ◽  
Vol 95 (10) ◽  
pp. 4635-4642 ◽  
Author(s):  
Hiroshi Kaji ◽  
Mika Yamauchi ◽  
Toru Yamaguchi ◽  
Takashi Shigematsu ◽  
Toshitsugu Sugimoto
Keyword(s):  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Disease Stage ◽  
Mineral Density ◽  
Increased Risk

Context: The effect of mild renal dysfunction on bone mineral density and fracture risk is uncertain. Objective: We evaluated whether mild renal dysfunction would affect bone mineral density (BMD) and the risk of vertebral fractures (VFs) in 659 postmenopausal women. Main Outcome Measures: Creatinine clearance (CCr) and the estimated glomerular filtration rate (eGFR) were calculated using the Cockcroft-Gault and the Modification of Diet in Renal Disease formulas, respectively. BMD was measured by dual-energy x-ray absorptiometry. Renal function was categorized by the criteria of the Kidney Disease Outcomes Quality Initiative Committee. Results: Comparison of fracture prevalence by chronic kidney disease stages revealed that the group of stage 3 or greater by eGFR had a significantly higher rate of VFs (45.3%) than stages 1 (23.8%) and 2 (25.3%) groups. In the stage 2 group, there were significant positive correlations between eGFR and BMD values at the femoral neck and radius as well as between CCr and BMD values at all sites. Moreover, postmenopausal women with VFs had lower eGFR and CCr than those without VFs in stage 2. When multivariable logistic regression analysis was performed with the presence of VFs as a dependent variable and CCr levels adjusted for years after menopause, smoking habit, alcohol intake, and lumbar spine BMD as an independent variable, CCr levels were identified as a factor associated with the presence of VFs in postmenopausal women with chronic kidney disease stage 2. Conclusions: The present study indicates that postmenopausal women with mild renal dysfunction are at increased risk for BMD decrease and VFs.

SP449RELATIONSHIP BETWEEN BONE MINERAL DENSITY AND SUBCLINICAL ATHEROSCLEROSIS IN DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i499-i499
Author(s):  
Volha Vasilkova ◽  
Tatiana Mokhort ◽  
Elena Naumenko ◽  
Ivan Pchelin ◽  
Valentina Bayrasheva ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Mineral ◽  
Subclinical Atherosclerosis ◽  
Diabetic Patients ◽  
Mineral Density
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