title: Association of reduction in bone mineral density with mortality in male hemodialysis patients.
abstract: In the present study we examined the relationship of bone mineral density (BMD) reduction with increased mortality in hemodialysis patients. A single-center prospective observational study was conducted on 269 male hemodialysis patients. The BMD in the distal third of the radius (DR1/3) and in the ultradistal radius (UR), which are enriched with cortical and cancellous bone, respectively, was measured twice using dual-energy X-ray absorptiometry (DXA) with a 1-year interval. Subjects were divided into two groups based on the presence or absence of BMD reduction. Survival was followed for 61.0 months, after which time 104 patients (39%) had died. A significant BMD reduction at the UR and DR1/3 occurred in 182 (68%) and 195 (72%) patients, respectively. Patients with BMD reduction in the UR, in contrast to the DR1/3, had a significantly lower survival rate than those without BMD reduction (P = 0.01). In Cox regression analysis, the rate of BMD change at the UR, in addition to patient age, diabetes mellitus, and serum albumin, emerged as an independent predictor for increased mortality (HR = 0.970, 95% CI 0.945-0.996). Our results suggest that BMD reduction at the UR might be a clinically relevant marker that predicts an increased risk of mortality in male hemodialysis patients.
authors.affiliation: Department of Metabolism, Osaka City University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kohno
authors.forename: Masaaki
authors.initials: M
authors.lastname: Inaba
authors.forename: Senji
authors.initials: S
authors.lastname: Okuno
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Maeno
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Maekawa
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yamakawa
authors.forename: Eiji
authors.initials: E
authors.lastname: Ishimura
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nishizawa
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001774:Blood Chemical Analysis; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D015996:Survival Rate
chemical_list: D015415:Biomarkers