Bone mineral loss in patients on maintenance hemodialysis with hyperphosphatemia treated with 1 alpha-hydroxycholecalciferol and calcium carbonate.
We investigated the relationship between bone mineral density loss and mean serum phosphate level for one year in 58 men on maintenance hemodialysis who were treated with 1 alpha-hydroxycholecalciferol and calcium bicarbonate. Bone mineral density of the femur head and neck was measured twice, 8 months apart, by dual energy X-ray absorptiometry (Hologic QDR 1000). Patients were divided into two groups according to their mean serum phosphate level during the year of the study. Group A had almost normal serum phosphate levels (mean, less than 6.0 mg/dl) and group B had hyperphosphatemia (mean, greater than or equal to 6.0 mg/dl). In group A, the mean bone mineral density was 0.825 +/- 0.122 g/cm2 at the beginning of the study and 0.828 +/- 0.118 g/cm2 8 months later. In group B, these values were 0.787 +/- 0.167 g/cm2 at the beginning and 0.762 +/- 0.171 g/cm2 8 months later. Bone mineral density did not decrease in group A, but it decreased significantly in group B (p less than 0.01). For all patients, the percent increase in the bone mineral density was inversely correlated with the mean serum phosphate value for the year of the study (r = -0.274, p less than 0.05). These results indicate the importance of serum phosphate control in patients on maintenance hemodialysis, even when they are being treated with 1 alpha-hydroxycholecalciferol and calcium carbonate.
Nishitani
H
H
Kidney Center, Shirasagi Hospital, Osaka, Japan.
Yamakawa
M
M
Nishizawa
Y
Y
Morii
H
H
D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects*; D002119:Calcium Carbonate / Q000627:therapeutic use*; D006801:Humans; D006887:Hydroxycholecalciferols / Q000627:therapeutic use*; D008875:Middle Aged; D010710:Phosphates / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects*
D006887:Hydroxycholecalciferols; D010710:Phosphates; D002119:Calcium Carbonate; C008088:alfacalcidol