Osteoprotegerin and uremic osteoporosis in chronic hemodialysis patients.
BACKGROUND
Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HD patients.


METHODS
This cross-sectional study has been realized on a cohort of 63 chronic HD patients.


METHODS
elderly prevalent HD patients with an age over 55 years old.


METHODS
previous bone disease or previous renal transplant; neoplasia; parathyroidectomy, hormone replacement therapy. The data regarding demographical and clinical characteristics, including treatments for mineral and cardiovascular complications, were recorded. Serum OPG and mineral markers levels were measured. BMD was assessed by calcaneus quantitative ultrasound; it measured broadband ultrasound attenuation, speed of sound (SOS) and stiffness index (STI).


RESULTS
The high OPG levels were associated with higher bone mineral density (OPG-SOS P = 0.003; R = 0.37; OPG-STI P = 0.03; R = 0.28). Malnutrition, anemia and advanced age correlated with bone demineralization. Males had higher bone density parameters than females. In patients treated with vitamin D (P = 0.005), the BMD was increased comparing to patients without these treatments.


CONCLUSIONS
OPG levels had directly correlated with bone mineral density parameters. Our study further confirms the critical role of OPG in the pathogenesis of uremic osteoporosis in ESRD. Whether the increased circulant OPG protect against bone loss in patients undergoing HD remains to be established.
Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. dnmoldovan@yahoo.com.|Nephrology and Dialysis Clinic, Emergency County Hospital, "Mihai Manasia", 3-5 Clinicilor Street, Cluj-Napoca, Romania. dnmoldovan@yahoo.com.
Diana
D
Moldovan
Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Crina
C
Rusu
Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Alina
A
Potra
Military Hospital Cluj-Napoca, Cluj-Napoca, Romania.
Ioan
I
Moldovan
Nefromed Dialysis Center Cluj-Napoca, Cluj-Napoca, Romania.
Ioan Mihai
IM
Patiu
Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Mirela
M
Gherman-Caprioara
Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania.
Ina Maria
IM
Kacso
D015502:Absorptiometry, Photon / Q000379:methods; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015519:Bone Density; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D053244:Osteoprotegerin / Q000097:blood*; D006435:Renal Dialysis / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
D015415:Biomarkers; D053244:Osteoprotegerin
Hemodialysis; Osteoporosis; Osteoprotegerin