Bone mineral density in hemodialysis patients with parathyroid dysfunction

Abstract

We have determined bone mineral density (BMD) in hemodialysis patients with various parathyroid function in an attempt to elucidate the pathology of bone abnormalities, and obtained the following results. It is desirable that BMD (DXA) in the dialysis patients is determined at the radius rather than at the lumber spine. A higher BMD value might be obtained because of osteosclerosis of the vertebra or abdominal vascular calcification. The correlation between the SPA and the DXA was favorable in determining BMD at the distal one-third of the radius. The correlation between Jensen's classification based on subperiosteal resorption, intact-PTH, and BMD(radius) was favorable. The annual decrease in BMD was 4.0% and 4.7% in the male patients within 8 years and the female within 6 years after starting dialysis, respectively, and thier BMD decreased to 70 at above mentioned year. The annual BMD decrease became larger in the patients with severe 2'HPT, i.e., 7.1% in the male patients and 10.0% in the female patients. BMD after PTX markedly increased in the patients showing BMD of less than 70 at PTX. The BMD in one male patient who showed aluminium induced osteomalacia in past history was maintained at a relatively favorable value. The biochemical examination of two female patients who became an aparathyroid state after PTX showed improved values, but their BMD gradually decreased without showing any increase.