title: [Bone metabolism in dialysis patient assessed by biochemical markers and densitometry].
abstract: A decrease in bone mineral density is common in patients with chronic renal failure. It is also a risk factor for fractures in this population. The aim of the study was to evaluate bone mineral density-BMD and some biochemical markers of bone metabolism in regard to the method of renal replacement therapy: hemodialysis or peritoneal dialysis. The studies were performed in two groups of patients: 2 patients maintained on chronic hemodialyses (HD) and 21 patients treated with chronic ambulatory peritoneal dialysis (CAPD). Bone mineral density was measured using dual energy X-ray absorptiometry (DEXA) in L2-L4 segments of lumbar spine and femoral neck. Concentrations of parathormon, osteocalcin, bone-specific alkaline phosphatase, serum CrossLaps (degradation products of C-terminal telopeptides of type I collagen) vitamin D3 were studied using commercially available kits. In femoral neck bone mineral density was significantly higher in CAPD patients when compared to HD, without significant differences in bone mineral density in lumbar spine. There was statistically significant correlation between BMD of the lumbar spine and time of hemodialysis (r = 0.39, p < 0.05). In CAPD patients BMD of lumbar spine correlated negatively with vitamin D3 (r = -0.54, p < 0.05), osteocalcin (r = -0.54, p < 0.05), and positively with body mass index-BMI (r = 0.63, p < 0.01). BMD of femoral neck correlated positively with BMI (r = 0.59, p < 0.01), and negatively with osteocalcin (r = -0.63, p < 0.05) and time on CAPD (r = -0.52, p < 0.05). On the basis of our finding we conclude that BMD depends on time of renal replacement therapy. Biochemical markers of bone metabolism poorly correlate with bone mineral density in dialyzed patients.
authors.affiliation: Klinika Nefrologii i Chorób Wewnetrznych AM w Białymstoku.
authors.forename: Jolanta
authors.initials: J
authors.lastname: Małyszko
authors.forename: Szymon
authors.initials: S
authors.lastname: Brzósko
authors.forename: Sławomir
authors.initials: S
authors.lastname: Wołczyński
authors.forename: Jacek S
authors.initials: JS
authors.lastname: Małyszko
authors.forename: M
authors.initials: M
authors.lastname: Myśliwiec
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology; D001862:Bone Resorption / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism*; D003720:Densitometry / Q000379:methods; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*
chemical_list: D015415:Biomarkers