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Journal of Bone and Mineral Metabolism

, Volume 27, Issue 2, pp 217–223 | Cite as

Determinants of prevalent vertebral fractures and progressive bone loss in long-term hemodialysis patients

  • Jan MaresEmail author
  • Kristina Ohlidalova
  • Sylvie Opatrna
  • Jiri Ferda
Original Article

Abstract

Skeletal fractures are common in hemodialysis (HD) patients. However, consensus regarding technique and site of bone examination has not been reached in HD patients. Seventy-two patients (44% females) aged 65 (1.4) years, treated with HD for 43 (4.6) months were examined with quantitative computed tomography and 53 of them re-examined after 1 year. Bone mineral density (BMD) of lumbar spine was established separately for cortical and trabecular bone, prevalent vertebral fractures were determined. Data are given as mean (standard error). At least one vertebral fracture was discovered in 15 (21%) patients. In a logistic regression model, fractures were best predicted by cortical BMD: OR 0.96 (CI 0.94, 0.99), p < 0.005. With a multiple regression analysis, time on dialysis was found to be independently correlated to cortical BMD (R = 0.35, p < 0.005). On follow-up, a decrease of BMD was detected, which occurred only in the cortical region and was significantly greater in females than in males: −7% (1.7) versus 1.2% (1.9), p < 0.005. A time-dependent loss of vertebral cortical bone occurs in HD patients, especially in females. This decrement may impose an increased risk of fractures on long-term dialysis patients.

Keywords

Hemodialysis Vertebral fractures Bone mineral density 

Notes

Acknowledgments

The study was supported by Research Project No. MSM0021620819 “Replacement of and Support to Some Vital Organs”, awarded by the Ministry of Education and Physical Training of the Czech Republic.

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Copyright information

© The Japanese Society for Bone and Mineral Research and Springer 2009

Authors and Affiliations

  • Jan Mares
    • 1
    Email author
  • Kristina Ohlidalova
    • 2
  • Sylvie Opatrna
    • 1
  • Jiri Ferda
    • 2
  1. 1.Department of Internal MedicineCharles University Teaching Hospital in PilsenPilsenCzech Republic
  2. 2.Department of RadiologyCharles University Teaching Hospital in PilsenPilsenCzech Republic

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