Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 2

Evaluation of Bone Mineral Density in Hemodialysis Patients

Oya Özdemir 1 ,Mukadder Ayşe Bilgiç 2
1 Department of Physical Medicine and Rehabilitation, Hacettepe University Faculty of Medicine, Ankara, Turkey
2 Ağrı Devlet Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ağrı, Türkiye
DOI : 10.4274/tftr.56.62

Objective: Low bone mass in end-stage renal disease patients, especially those undergoing hemodialysis, can lead to serious health problems such as fragility fractures and may have negative impact on their quality of life. The aim of this study was to determine bone mineral density (BMD) in a group of hemodialysis patients and to evaluate its relationship with several clinical parameters and markers of biochemical bone turnover.

Materials and Methods: Thirty hemodialysis patients, with a mean age of 49.7±16.0 years, were included in the study. The BMD was measured at the lumbar spine (L2-L4) and at the proximal femur by dual-energy X-ray absorptiometry (DXA). Markers of biochemical bone turnover such as calcium, phosphorus, alkaline phosphatase, intact parathyroid hormone (iPTH), plasma bicarbonate, blood pH, serum albumin, and hematocrit levels were measured before the hemodialysis session. 

Results: The mean T-scores at lumbar spine and femur neck were -1.6±0.8 and -2.6±1.1, respectively. According to the World Health Organization criteria based on BMD T-score at lumbar spine, 7% of patients were osteoporotic, 60% osteopenic, and 33% normal. On the other hand, at femur neck, the results were 50% osteoporotic, 40% osteopenic, and 10% normal. No significant differences were observed in age, duration of hemodialysis and iPTH levels between the patients with or without osteoporosis at femur neck. No correlation was found between BMD at both sites and age, duration of hemodialysis, serum calcium, phosphorus, alkaline phosphatase and iPTH levels. There were no statistically significant differences in BMD and biochemical markers of bone turnover between sexes. 

Conclusion: In this study, we showed that 53% of the patients undergoing hemodialysis have osteoporosis, especially at femur neck. Thus, we suggest regular monitoring of the femur neck BMD in order to improve bone health of the chronic hemodialysis patients.

Keywords : Hemodialysis, osteoporosis, bone mineral density, DXA