The Factors Effective on Bone Mineral Density in Peritoneal Dialysis Patients

Abstract

Bone mineral metabolism deteriorates gradually beginning from the early stages of chronic kidney disease (CKD). But, the KDIGO-2009 guideline could not provide high quality data regarding the biochemical tests related with bone mineral disorder in CKD. The aim of our study was to analyse the relationship between bone mineral densitometry and clinical and biochemical parameters in chronic peritoneal dialysis (PD) patients. Besides the demographic parameters, routine hematological and biochemical analysis results of PD patients followed up in our clinic were recorded. Bone mineral density (BMD) was measured at lumbar vertebrae and femur neck using DEXA machine. The mean lumbar T- and femur T-score were -1.03±1.20 (minimum:-3.73; maximum:+1.75) and -2.49±1.20 (minimum:-4.63; maximum:-0.51), respectively. Lumbar T score was significantly higher than femur T score (p

Keywords

• Bone mineral density, peritoneal dialysis, osteoporosis

The Factors Effective on Bone Mineral Density in Peritoneal Dialysis Patients

Abstract

Kronik böbrek yetersizliği (KBY)'nin erken evrelerinden başlayarak kemik-mineral metabolizması giderek bozulur. Ancak KDIGO-2009 kılavuzunda KBY'de kemik mineral bozukluğu ile ilişkili verilerin çoğunluğunun kanıt düzeyi düşük olduğu ifade edilmiştir. Bu çalışmada, kronik periton diyalizi (PD) hastalarımızın kemik mineral dansitesi (KMD) ölçümleri ile klinik ve biyokimyasal parametreleri arasındaki ilişkiyi araştırdık. Hastanemizin PD ünitesinden takipli 53 hastanın demografik verileri yanında rutin hematolojik ve biyokimyasal tetkikleri kaydedildi. Hastalarda lomber vertebra ve femur boynundan DEXA cihazıyla kemik mineral dansitesi (KMD) ölçümü yapıldı. Hastaların lomber-T skoru -1.03±1.20[(-3.73)-(+1.75)] bulunur iken femur-T skoru -2.49±1.20[(-4.63)-(0.51)] olarak saptandı. Lomber T skoru, femur T skorundan anlamlı olarak daha yüksekti (p<0.0001). Sekiz hastanın KMD değeri normalken 16'sında osteopenia, 29'unda osteoporoz saptandı. Femur-T skor ile yaş arasında negatif korelasyon saptanırken(r=-0.36, p=0.026), lomber-T skoruyla yaş arasında korelasyon saptanmadı(r=-0.17, p=0.21). Femur-T skoruyla ilişkili parametrelerin çok değişkenli analizi yapıldığında; yaş ve VKİ, femur-T skorunun bağımsız belirleyicileri olduğu, cinsiyet, PTH düzeyi ve aktif D vitamin kullanımının anlamlı olarak etkilemediği saptandı. Yaş negatif, VKİ ise pozitif yönde etkiliydi. PD hastalarında femur boynundan yapılan KMD ölçümleri lomber vertebradan yapılan ölçümlere göre daha anlamlıdır. PD hastalarının çoğunda KMD düşüklüğü mevcuttur ve özellikle yaş ve VKİ majör etkili faktörlerdir

Keywords

• Kemik mineral yoğunluğu, periton diyalizi, osteoporoz

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