Abstract: FR-PO410
Associations between Femoral Neck Bone Mineral Density, Kt/Vurea, and Mortality in Patients on Hemodialysis
Session Information
- Hemodialysis Epidemiology and Outcomes
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Mikami, Tomio, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
- Masaki, Takao, Hiroshima Daigaku, Higashihiroshima, Hiroshima, Japan
Background
Several studies have reported the relationships between bone mineral density (BMD), clinical data, and mortality in patients on hemodialysis (HD). However, the relationship between BMD and dialysis efficiency is unclear, and it is unknown which site has a BMD most strongly associated with mortality.
Methods
The cohort comprised 291 patients on maintenance HD. We evaluated the BMD parameters and influence of the BMD at different sites on mortality. BMD, body composition, and clinical data were obtained at baseline and followed up for 3 years. BMD was measured at femoral neck, distal mid-third radius, and lumbar spine using dual energy X-ray absorptiometry. BMD was expressed as percentage of the young adult mean and used to define osteoporosis (BMD<70%), osteopenia (70%≤BMD<80%), and normal BMD (BMD≥80%). Multiple regression analysis for BMD and Kaplan-Meier survival and Cox-Hazard analyses were performed.
Results
The mean age was 65±12 years, 67% were men, the dialysis duration was 73 (36–141) months, and diabetes prevalence was 42.6%. The femoral neck, radius, and lumbar spine were osteoporosis in 118 (40.6%), 90 (30.9%), and 31 (10.7%) patients, respectively, and were osteopenia in 74 (25.4%), 43 (14.8%), and 26 (8.9%) patients, respectively. Compared with the normal BMD group, patients with osteoporosis or osteopenia at all three sites had a significantly higher age, tartrate-resistant acid phosphatase 5b concentration, and Kt/Vurea, but a significantly lower geriatric nutritional risk index, body mass index, and lean tissue index (P<0.05). Kt/Vurea was a significant predictor of the BMD at the femoral neck (β -0.16), radius (β -0.17), and lumbar spine (β -0.23) after adjusting for age, sex, dialysis duration, and diabetes (P<0.05). The 3-year survival rates were 76%, 89%, and 91%, respectively, in patients with osteoporosis, osteopenia, and normal BMD in the femoral neck (P<0.05); but did not differ according to the BMD of the radius and lumbar spine. The femoral neck BMD was a significant predictor of 3-year all-cause mortality, while the radius and lumbar spine BMDs were not.
Conclusion
In patients on maintenance HD, the femoral neck BMD was a significant predictor of 3-year all-cause mortality. The results also suggested an association between BMD and Kt/Vurea.
Funding
- Private Foundation Support