Kidney Week

Abstract: SA-PO664

Bone Mineral Density in Patients with CKD: Hip Is More Affected Than Spine

Session Information

• Bone and Mineral Metabolism: Clinical - II
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 402 Bone and Mineral Metabolism: Clinical

Authors

• Bezerra de carvalho, Kalyanna Soares, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil;, São Paulo, Brazil

Kalyanna Soares Bezerra de carvalho,

• Custodio, Melani, Universidade de São Paulo, São Paulo, Brazil

Melani Custodio,

• Moyses, Rosa M.A., Universidade Nove de Julho, São Paulo, Brazil

Rosa M.A. Moyses,

• Vasco, Raquel F. V., Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil;, São Paulo, Brazil

Raquel F. V. Vasco,

• Jorgetti, Vanda, Universidade de Sao Paulo, Sao Paulo, Brazil

Vanda Jorgetti,

• Elias, Rosilene M., Universidade de Sao Paulo, Sao Paulo, Brazil

Rosilene M. Elias,

Background

Patients with chronic kidney disease (CKD) have a higher risk of fracture than the general population. Osteoporosis is a co-prevalent disease, twice as common in this population, and dual-energy X-ray absorptiometry (DXA) has been recognized to predict fracture in CKD. We hypothesized that low bone mineral density (BMD) will be more prevalent as kidney function decreases and will be associated with biomarkers of mineral and bone disease.

Methods

We investigated the features of BMD in patients with CKD stages 1-5, in a decade observation. DXA obtained from January 1^st 2007 to Dec 31^st 2017, clinical, demographic and biochemical data at the time of image acquisition were recorded. A total of 1,172 patients were enrolled into this study (81.3% women, 79.9 % white, and 8.6% diabetic).

Results

Osteopenia and osteoporosis in at least one site (total hip or spine) were found in 32.7% and 20.0% of patients, respectively. As CKD progresses, the percentage of patients with normal BMD decreases whereas the percentage of osteopenia and osteoporosis increases, which was mostly due to the total hip involvement. Older age and hyperparathyroidism (PTH>65pg/ml) were independently risk factors for osteopenia/osteoporosis at total hip. Regarding spine, female gender, older age and higher iCa were independently associated with the risk of osteopenia/osteoporosis in the entire population. The odds ratios for osteoporosis/osteopenia at the hip were 1.14 (95% CI: 2.10-3.85) and 1.05 (95% CI: 1.87-3.35) for patients with eGFR <15 and 15-30 ml/min/1.73m², respectively. None eGFR category was significantly associated with the risk of osteoporosis/osteopenia at the spine.

Conclusion

We confirmed the risk factors for low BMD already described for the general population, and demonstrated the association with impaired renal function and the more expressive hip involvement than spine. In addition, hyperparathyroidism seems to be an additional, and sizable risk factor in this population.