Factors affecting bone mineral density in hemodialysis patients with diabetic nephropathy

Abstract

Background: It remains undetermined whether bone mineral density (BMD) of hemodialysis (HD) patients with diabetes mellitus (DM) is reduced or not. The present study was performed to compare BMD between HD patients with DM and chronic glomerulonephritis (CGN). We analyzed the factors which affected BMD of 139 patients with chronic HD enrolled in this cross-sectional study. Methods: BMD of forearm [1/3-radius (R) and ultradistal (UD)-R] were measured by dual-energy x-ray absorptiometry. Results: 1/3R-BMD and UDR-BMD of DM patients were comparable to those of CGN patients. In DM patients, body mass index (BMI) was positively correlated with UDR-BMD, serum levels of PTH and creatinine were negatively correlated with 1/3R-BMD, and serum level of β2-microglobulin (βMG) was positively correlated with UDR-BMD. In CGN patients, duration of HD and height were negatively correlated with 1/3R- and UDR-BMD, serum levels of uric acid and triglyceride were positively correlated with 1/3R- and UDR-BMD, and serum level of total cholesterol was positively correlated with UDR-BMD. In stepwise regression analysis, BMI and serum levels of creatinine and βMG were selected for UDR-BMD in DM patients, although serum PTH level was selected for 1/3R-BMD. Conclusion: BMD at forearm was comparable between DM and CGN in HD patients. The factors affecting BMD seemed to be different between DM and CGN.