Abstract: PUB056
Associations of Body Composition, Bone Mineral Density, Serum Phosphate, and Magnesium Levels in Hemodialysis Patients
Session Information
Category: Bone and Mineral Metabolism
- 402 Bone and Mineral Metabolism: Clinical
Authors
- Mizuiri, Sonoo, Ichiyokai Harada Hospital, Hiroshima, Japan
- Nishizawa, Yoshiko, Ichiyokai Harada Hospital, Hiroshima, Japan
- Yamashita, Kazuomi, Ichiyokai Harada Hospital, Hiroshima, Japan
- Usui, Kohji, Ichiyokai Ichiyokai Clinic, Hiroshima, Japan
- Arita, Michiko, Ichiyokai East clinic, Hiroshima, Japan
- Naito, Takayuki, Ichiyokai Yokokawa Clinic, Hiroshima, Japan
- Doi, Shigehiro, Hiroshima University Hospital, Hiroshima, Japan
- Masaki, Takao, Hiroshima University Hospital, Hiroshima, Japan
- Shigemoto, Kenichiro, Ichiyokai Harada Hospital, Hiroshima, Japan
Background
Sarcopenia, osteoporosis, hyperphosphatemia, and hypomagnesemia are reportedly associated with mortality in hemodialysis patients. This study aimed to assess the associations of body composition, bone mineral density (BMD), serum phosphate (P) and magnesium (Mg) levels in maintenance hemodialysis (MHD) patients.
Methods
Pre-dialysis laboratory data, post-dialysis body composition parameters by the Body Composition Monitor (Fresenius), and radius, lumbar spine, and femoral bone mineral density (BMD) using dual energy X-ray absorptiometry were assessed in MHD patients. Body composition, BMD, and clinical data were compared based on serum P and Mg levels. Multiple regression analyses for body cell mass index (BCMI): fat-free mass without extracellular water, and overhydration/extracellular water (OH/ECW) were performed, respectively.
Results
Among 264 patients (male: 65%, diabetes: 42%), mean age was 65±12 years and the median dialysis vintage was 79 (39–144) months. Serum P tertiles (T1–T3) were <4.5, 4.5–5.5, and <5.5 mg/dl. The low (T1) serum P group exhibited significantly (P<0.05) lower normalized protein nitrogen appearance (nPNA), intact parathyroid hormone (iPTH), lean tissue index, BCMI (6.5±1.8, 6.9±1.8, and 7.2±2.0 kg/m2), intracellular water and significantly higher OH/ECW (9.2±10.0, 8.9±9.8, and 6.4±8.9, P<0.05) than other groups; BMD and coronary artery calcification score (CACS) did not differ. Serum Mg tertiles were <2.3, 2.4–2.5, and <2.5 mg/dl. Compared with other groups, the low (T1) serum Mg group showed lower nPNA and iPTH (P<0.05), but no significant differences in body composition parameters, BMD, or CACS. BCMI was significantly (P<0.05) associated with age (β:-0.30), presence of diabetes (β:-0.16), serum albumin (β:0.13), serum P (β:0.12), femoral BMD (β:0.23) [or radius BMD (β:0.41)], but not serum Mg or lumbar spine BMD. OH/ECW was significantly (P<0.05) associated with the presence of diabetes (β:0.21), serum P (β:-0.13), and femoral BMD (β:-0.19) but not age, serum albumin, Mg, or radius or lumbar spine BMD.
Conclusion
In MHD patients, associations among serum P levels (but not serum Mg levels), body composition parameters (BCMI, OH/ECW) and BMD were observed; serum P <4.5 mg/dl may indicate worse body composition and lower BMD.
Funding
- Private Foundation Support