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Loss of bone mineral density and trabecular bone score in elderly hemodialysis patients: a 2-year follow-up, prospective, single-centre study

  • Nephrology - Original Paper
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Abstract

Background

Low bone mineral density (BMD) and trabecular bone score (TBS) are established risk factors for fractures even in hemodialysis population and they seem to be significantly lower in comparison with general population. The aim of our study was to describe 2-year loss of BMD and TBS and their predictors in hemodialysis patients.

Methods

From 59 non-selected patients (mean age 67.6 ± 13.1 years) from one dialysis centre, treated with hemodiafiltration (HDF), clinical and laboratory characteristics were obtained and densitometry examinations (with BMD and TBS results) were performed initially and at the end of 2-year follow-up.

Results

Two-year decrease in BMD of lumbar spine reached 4.1% (ns), of proximal femur 9.1% (p = 0.004), and of femoral neck 1.3% (ns). In the co-educated cohort, BMD decrease in all the sites correlated significantly with age and only the change of BMD of lumbar spine was negatively associated with serum calcium (r = − 0.39; p = 0.04) and dialysis vintage (r = − 0.387; p = 0.062), no other predictors of BMD loss were identified. Some predictors of BMD loss were identified with regard to gender. TBS decrease was 0.05 (3.9%; p = 0.03), and similarly, it was not predicted by any of selected parameters. No differences in BMD changes or TBS were observed between the patients with and without fractures.

Conclusions

In patients with HDF, significant BMD and TBS annual losses were observed, and they were associated only with age and (in BMD of lumbar spine) with serum calcium and dialysis vintage.

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Acknowledgements

The publication was supported by PROGRES Q36 by MH CZ-DRO (“Kralovske Vinohrady University Hospital—FNKV, 00064173”). We would like to thank Mr. Michael Allen for language editing.

Funding

This study was funded by Progres Q36 and MH CZ-DRO (“Kralovske Vinohrady University Hospital—FNKV, 00064173”).

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Authors and Affiliations

  1. 2nd Department of Medicine, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Prague, Czech Republic

    Ludmila Brunerová & Jana Potočková

  2. Bone Metabolism Unit, Affidea, Prague, Czech Republic

    Petr Kasalický

  3. Dialysis Centre, Fresenius Medical Care, Prague-Vinohrady, Czech Republic

    Jana Verešová & Renata Lažanská

  4. 1st Department of Medicine, Faculty Hospital Kralovske Vinohrady and Third Faculty of Medicine, Charles University, Šrobárova 50, 100 34, Prague 10, Czech Republic

    Ivan Rychlík

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  1. Ludmila Brunerová
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  2. Petr Kasalický
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Correspondence to Ludmila Brunerová.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Brunerová, L., Kasalický, P., Verešová, J. et al. Loss of bone mineral density and trabecular bone score in elderly hemodialysis patients: a 2-year follow-up, prospective, single-centre study. Int Urol Nephrol 52, 379–385 (2020). https://doi.org/10.1007/s11255-020-02378-1

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