Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life.
CONCLUSIONS
Postmenopausal hemodialysis patients are at risk of complications related to renal mineral and bone disorder, and postmenopausal osteoporosis. In 112 postmenopausal hemodialysis patients, free estrogen index was positively correlated with bone mineral density (BMD) Z-score and the annual percent change of BMD in multiple regression analysis. Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life.


BACKGROUND
Women on dialysis are not only at risk of developing mineral and bone disorder, but also suffer from postmenopausal osteoporosis. We assessed the effect of sex hormones on bone metabolism in postmenopausal hemodialysis patients.


METHODS
We enrolled 112 postmenopausal hemodialysis patients with a mean age of 68.4 ± 10.4 years. We measured the serum levels of estradiol, testosterone, sex hormone-binding globulin (SHBG), and intact parathyroid hormone (intact-PTH), as well as bone metabolism parameters and radial bone mineral density (BMD). The free estrogen index (FEI) was calculated from the estradiol and SHBG values. After conventional dialysis was performed for 12 months, BMD was measured again and the annual percent change was calculated. Estradiol and SHBG were also measured in 25 postmenopausal women without chronic kidney disease.


RESULTS
Estradiol levels were higher in the hemodialysis patients than in the postmenopausal women without chronic kidney disease. In patients with relatively normal bone turnover (intact-PTH: from 150 to 300 pg/ml), the FEI showed a positive correlation with the BMD Z-score. The annual percent change of BMD showed a positive correlation with the FEI according to multiple regression analysis.


CONCLUSIONS
Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life.
Sugiya
N
N
Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan.
Nakashima
A
A
Takasugi
N
N
Kawai
A
A
Kiribayashi
K
K
Tanaka
J
J
Kohno
N
N
Yorioka
N
N
D000368:Aged; D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000378:metabolism; D004958:Estradiol / Q000097:blood / Q000502:physiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D011884:Radius / Q000503:physiopathology; D006435:Renal Dialysis / Q000009:adverse effects*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism
D012738:Sex Hormone-Binding Globulin; D004958:Estradiol