Low bone volume--a risk factor for coronary calcifications in hemodialysis patients.
OBJECTIVE
There is increasing evidence that altered bone metabolism is associated with cardiovascular calcifications in patients with stage 5 chronic kidney disease on hemodialysis (HD). This study was conducted to evaluate the association between bone volume, turnover, and coronary calcifications in HD patients.


METHODS
In a cross-sectional study, bone biopsies and multislice computed tomography were performed in 38 HD patients. Bone volume/total volume, activation frequency, and bone formation rate/bone surface were determined by histomorphometry and coronary calcifications were quantified by Agatston scores.


RESULTS
Prevalence of low bone turnover was 50% and of low bone volume was 16%. Among the studied traditional cardiovascular risk factors, only age was found to be associated with coronary calcifications. Lower bone volume was a significant risk factor for coronary calcifications during early years of HD, whereas this effect was not observed in patients with dialysis duration >6 yr. Histomorphometric parameters of bone turnover were not associated with coronary calcifications.


CONCLUSIONS
Low bone volume is associated with increased coronary calcifications in patients on HD.
Adragao
Teresa
T
Nephrology Department, Santa Cruz Hospital, Lisbon, Portugal.
Herberth
Johann
J
Monier-Faugere
Marie-Claude
MC
Branscum
Adam J
AJ
Ferreira
Anibal
A
Frazao
Joao M
JM
Dias Curto
Jose
J
Malluche
Hartmut H
HH
D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D016723:Bone Remodeling; D002114:Calcinosis / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007085:Ilium / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009929:Organ Size; D006435:Renal Dialysis / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D055815:Young Adult