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01-12-2018 | Original Article

Chronic hemodialysis is associated with lower trabecular bone score, independent of bone mineral density: a case-control study

Authors: Roxana Dusceac, Dan Alexandru Niculescu, Ramona Dobre, Madalina Cristina Dragne, Catalin Tacu, Ileana Peride, Cristiana David, Ionel Checherita, Catalina Poiana

Published in: Archives of Osteoporosis | Issue 1/2018

Abstract

Summary

We measured trabecular bone score (TBS) in 98 patients on permanent hemodialysis (HD) and 98 subjects with similar bone mineral density and normal kidney function. TBS was significantly lower in HD patients, indicating deteriorated bone microarchitecture, independent of bone mass. This might partially explain the increased fracture risk in HD.

Purpose

In the general population, trabecular bone score (TBS) was shown to predict fracture independent of bone mineral density (BMD). In end-stage renal disease patients on hemodialysis (HD), the value of TBS is beyond that of BMD in currently unclear. Our aim was to assess lumbar spine (LS) TBS in HD patients compared with subjects with normal kidney function matched for age, sex, and LS BMD.

Methods

We assessed TBS and LS and femoral neck (FN) BMD in 98 patient on permanent HD (42.8% males; mean age 57.5 ± 11.3 years; dialysis vintage 5.5 ± 3.8 years) and 98 control subjects (glomerular filtration rate > 60 mL/min) using DXA. We simultaneously controlled for sex, age (± 3 years), and LS BMD (± 0.03 g/cm²).

Results

HD patients had significantly lower LS TBS (0.07 [95% CI 0.03–0.1]; p = 0.0004), TBS T-score (0.83 SD [95% CI 0.42–1.24]; p = 0.0001)) and TBS Z-score (0.81 SD [95% CI 0.41–1.20]; p = 0.0001) than matched controls. TBS significantly correlated with LS BMD in both HD patients (r = 0.382; p = 0.001) and controls (r = 0.36; p = 0.002). The two regression lines had similar slopes (0.3 vs. 0.28; p = 0.84) with different intercepts (0.88 vs. 0.98). TBS adjustment significantly increased the 10-year fracture risk from 3.7 to 5.3 for major osteoporotic fracture and from 0.9 to 1.5 for hip fracture.

Conclusions

HD patients have lower TBS than controls matched for LS BMD, indicating altered bone microarchitecture. Also, the magnitude of TBS reduction in HD patients is constant at any LS BMD. Adjustment for TBS partially corrects the absolute 10-year fracture risk.

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Title: Chronic hemodialysis is associated with lower trabecular bone score, independent of bone mineral density: a case-control study
Authors: Roxana Dusceac
Dan Alexandru Niculescu
Ramona Dobre
Madalina Cristina Dragne
Catalin Tacu
Ileana Peride
Cristiana David
Ionel Checherita
Catalina Poiana
Publication date: 01-12-2018
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-018-0541-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Chronic hemodialysis is associated with lower trabecular bone score, independent of bone mineral density: a case-control study

Abstract

Summary

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Summary

Purpose

Methods

Results

Conclusions

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