Mineral and bone disorders in dialysis patients with chronic kidney disease: Focus on diagnostics
Background. Chronic kidney disease (CKD) is a socially significant problem worldwide, affecting 14.2% of the population. CKD can cause complications that require timely detection and adequate treatment to prevent their progression. One of the complications associated with CKD is mineral bone disease (MBD). Dual-energy X-ray absorptiometry allows for the detection of early changes in bone structure in patients with CKD.N.V. Leonova, L.R. Vykhrystenko
Objective: To identify clinical, laboratory, and instrumental parameters of MBD in patients undergoing chronic dialysis at stage C5 CKD.
Material and methods. The study included 40 patients aged 50 to 74 years; all participants were receiving renal replacement therapy. The survey included anthropometric assessment, body mass index calculation, serum creatinine, urea, alkaline phosphatase, calcium, phosphorus, and parathyroid hormone levels, and X-ray densitometry.
Results. MBD was detected in 25 (62.50%) respondents, with a significant proportion of female patients – 16 (64.0%) vs. 9 (36.0%) males. Osteoporosis was diagnosed in 7 (43.75%) females. Menopause was a risk factor for MBD (p = 0.024). Parathyroid hormone levels were 4.18 times higher than the upper reference value, with a median of 257.00 pg/ml, with no statistical differences by gender. Hypo-/hypercalcemia was present in approximately 25% of patients, and hypo-/hyperphosphatemia in 20%. Abdominal obesity and high body mass index were detected in 82.5% of patients, with men more likely to have stage 1 obesity (40.0%) and women more likely to be overweight (40.0%).
Conclusion. X-ray densitometry is a reliable method for verifying MBD in patients with CKD, while surrogate markers of bone metabolism such as parathyroid hormone, calcium, phosphorus, and alkaline phosphatase, which exhibit high variability, can be used as additional markers.
Keywords
chronic kidney disease
dialysis
X-ray densitometry
bone mineral disorders
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About the Authors
Natalya V. Leonova, MD, senior lecturer at the Department of general medical practice, Vitebsk State Medical University, Vitebsk, Republic of Belarus.Е-mail: nataleon1881@gmail.com
ORCID: https://orcid.org/0009-0000-8373-885X
Lyudmila R. Vykhristenko, MD, Dr. Sci. (Medicine), professor, head of the Department of general medical practice, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Е-mail: ludros@mail.ru
ORCID: https://orcid.org/0000-0002-6149-6973
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