[Clinical study of concerning factors of decreased bone mineral content in hemodialysis patients].
We investigated bone mineral content and factors related to decreased bone mineral content in maintenance hemodialysis patients. Bone mineral contents, epsilon GS/D, radius-bone mineral content (R-BMC) and L3-bone mineral density (L3-BMD), were measured with a micro densitometer, a bone mineral analyzer and a dual energy quantative CT scanner, and relative bone mineral contents (% epsilon GS/D, %R-BMC and %L3-BMD) were calculated respectively. The desferrioaxmine infusion test was carried out for diagnosis of aluminium associated bone disease, and an elevated level of aluminium (delta aluminium) was observed. There was reverse correlation between epsilon GS/D and age in female hemodialysis patients. Serum bone gla protein, alkaline phosphatase and PTH-C levels were high in cases with increased epsilon GS/D and who were receiving little medication with activated Vitamin D in maintenance hemodialysis patients. A correlation was observed between delta aluminium and total medication of aluminium hydroxide-gel. Hemodialysis patients with bone pain had long term hemodialysis, high total medication of aluminium and high aluminium. Relative bone mineral contents (% epsilon GS/D, %R-BMD) were useful for estimating bone mineral content in hemodialysis patients. Hemodialysis patients were divided in four groups by PTH-C and delta aluminium levels as follow, 1) normal, 2) aluminium associated bone disease, 3) secondary hyperparathyroidism with aluminium associated bone disease, 4) secondary hyperparathyroidism. These results indicate that secondary hyperparathyroidism, and medication with aluminium may play a role in decreased bone mineral content in hemodialysis patients, and menopause may also be an important factor in female hemodialysis patients.
Second Department of Internal Medicine, Nagasaki University School of Medicine.
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Kohara
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000378:metabolism; D000535:Aluminum / Q000378:metabolism; D000536:Aluminum Hydroxide / Q000009:adverse effects; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology* / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000378:metabolism; D015663:Osteoporosis, Postmenopausal / Q000150:complications; D010281:Parathyroid Hormone / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects*; D012737:Sex Factors
D010281:Parathyroid Hormone; D015675:Osteocalcin; D010758:Phosphorus; D000536:Aluminum Hydroxide; D000535:Aluminum; D000469:Alkaline Phosphatase; D002118:Calcium