Assessment of Bone Mineral Density in Patients Undergoing Hemodialysis; An Iranian Population-Based Study

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 + SI) 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 HI) 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.

Automated summary

The study investigated bone mineral density and biochemical markers in 200 hemodialysis patients, finding a decrease in BMD with increasing age and duration of HD. Higher BMI was associated with higher bone mass density, suggesting the necessity of bone density assessment in HD patients.