Assessment of bone mineral density in patients undergoing hemodialysis; An Iranian population-based study

Abstract

Background: End-stage renal disease (ESRD) is a condition in which bone turnover and metabolism is impaired; thus, osteoporosis and low bone density are subsequently inevitable. We aimed to determine bone mineral density (BMD) and biochemical markers, and associated factors in hemodialysis (HD) patients. Methods: Patients aged 30-70 years undergoing HD between 2015 to 2019 were enrolled in this cross-sectional study. BMD measured by dual energy x-ray absorptiometry (DEXA) and biochemical laboratory tests were assessed in 200 patients undergoing HD. Statistical analysis was based on t test, Pearson, regression and Mann-Whitney tests using SPSS 16. Results: Two hundred patients were investigated. Sixty percent of the patients were female. Mean ± SD of participants' age was 58.6 (±11.63) years and mean ± SD for duration of HD was 45.69 (± 43.76) months. Osteoporosis was found in 48% (n = 96) and low bone density in 36% (n = 76) of our patients. General osteoporosis was more frequent in those undergoing HD for more than 3 years, although not significantly (P = 0.093, odds ratio [OR] = 0.37). However, regional osteoporosis in hip and femoral neck, but not spine vertebrae, were significantly higher after three years of HD (P = 0.036, OR = 0.27; P = 0.042, OR = 0.27; and P = 0.344, OR = 0.56, respectively). Increased body mass index (BMI) correlated negatively with osteoporosis (P = 0.050). Conclusion: With increasing age and duration of HD, BMD decreases. Higher BMI was associated with higher bone mass density. Bone density assessment seems to be necessary in patients undergoing HD.