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Evaluation of bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hemodialysis patients.
Osteoporos Int 2012; 23(10):2543-50OI

Abstract

Hemodialyzed patients have decreased bone strength not completely characterized. We evaluated bone microarchitecture in hemodialysis patients and compared it to that of subjects without renal disease by high-resolution peripheral quantitative computed tomography (HR-pQCT). Hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women.

INTRODUCTION

Although fracture risk is greatly increased in dialysis patients, the corresponding decreased in bone strength has not been completely characterized.

METHODS

We evaluated volumetric bone mineral density (vBMD) and bone microstructure by HR-pQCT at the distal radius and tibia in 50 hemodialyzed (HD) patients (30 females, mean age 53.2 ± 6 years and 20 males, mean age 59.1 ± 11 years) and 50 sex- and age-matched controls.

RESULTS

At the distal radius HD, women showed a 29% reduction in total and trabecular density and trabecular bone volume fraction (p < 0.0001) compared to controls. Trabecular number was reduced by 25% (p < 0.0001), while trabecular separation was increased by 51%. Cortical thickness (-40%, p < 0.0001) and cortical area (-42%, p < 0.0001) were the parameters most reduced, while compact density was the parameter least reduced (-15%, p < 0.0001). Similar findings were found at the tibia. In HD men, HR-pQCT at the distal radius and tibia showed a reduction in volumetric density and microstructure parameters to a lesser extent than in women. In the hemodialyzed group, cortical thickness at the radius was negatively correlated with age both in women and men. At the distal radius and tibia, we found significant negative correlations between Log iPTH and total alkaline phosphatase with cortical vBMD(r = -0.48, p < 0.01; r = -0.69, p < 0.001), thickness (-0.37, p < 0.05; r = -0.60, p < 0.001), and area ((r = -0.43, p = 0.02; r = -0.65, p < 0.001) but only in women.

CONCLUSION

We conclude that hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women.

Authors+Show Affiliations

Instituto de Investigaciones Metabólicas, Universidad del Salvador, Libertad 836 1 piso, Buenos Aires 1012, Argentina. negri@casasco.com.arNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22234812

Citation

Negri, A L., et al. "Evaluation of Bone Microarchitecture By High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) in Hemodialysis Patients." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 23, no. 10, 2012, pp. 2543-50.
Negri AL, Del Valle EE, Zanchetta MB, et al. Evaluation of bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hemodialysis patients. Osteoporos Int. 2012;23(10):2543-50.
Negri, A. L., Del Valle, E. E., Zanchetta, M. B., Nobaru, M., Silveira, F., Puddu, M., ... Zanchetta, J. R. (2012). Evaluation of bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hemodialysis patients. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 23(10), pp. 2543-50. doi:10.1007/s00198-011-1890-9.
Negri AL, et al. Evaluation of Bone Microarchitecture By High-resolution Peripheral Quantitative Computed Tomography (HR-pQCT) in Hemodialysis Patients. Osteoporos Int. 2012;23(10):2543-50. PubMed PMID: 22234812.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT) in hemodialysis patients. AU - Negri,A L, AU - Del Valle,E E, AU - Zanchetta,M B, AU - Nobaru,M, AU - Silveira,F, AU - Puddu,M, AU - Barone,R, AU - Bogado,C E, AU - Zanchetta,J R, Y1 - 2012/01/11/ PY - 2011/10/21/received PY - 2011/12/19/accepted PY - 2012/1/12/entrez PY - 2012/1/12/pubmed PY - 2013/5/25/medline SP - 2543 EP - 50 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 23 IS - 10 N2 - UNLABELLED: Hemodialyzed patients have decreased bone strength not completely characterized. We evaluated bone microarchitecture in hemodialysis patients and compared it to that of subjects without renal disease by high-resolution peripheral quantitative computed tomography (HR-pQCT). Hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women. INTRODUCTION: Although fracture risk is greatly increased in dialysis patients, the corresponding decreased in bone strength has not been completely characterized. METHODS: We evaluated volumetric bone mineral density (vBMD) and bone microstructure by HR-pQCT at the distal radius and tibia in 50 hemodialyzed (HD) patients (30 females, mean age 53.2 ± 6 years and 20 males, mean age 59.1 ± 11 years) and 50 sex- and age-matched controls. RESULTS: At the distal radius HD, women showed a 29% reduction in total and trabecular density and trabecular bone volume fraction (p < 0.0001) compared to controls. Trabecular number was reduced by 25% (p < 0.0001), while trabecular separation was increased by 51%. Cortical thickness (-40%, p < 0.0001) and cortical area (-42%, p < 0.0001) were the parameters most reduced, while compact density was the parameter least reduced (-15%, p < 0.0001). Similar findings were found at the tibia. In HD men, HR-pQCT at the distal radius and tibia showed a reduction in volumetric density and microstructure parameters to a lesser extent than in women. In the hemodialyzed group, cortical thickness at the radius was negatively correlated with age both in women and men. At the distal radius and tibia, we found significant negative correlations between Log iPTH and total alkaline phosphatase with cortical vBMD(r = -0.48, p < 0.01; r = -0.69, p < 0.001), thickness (-0.37, p < 0.05; r = -0.60, p < 0.001), and area ((r = -0.43, p = 0.02; r = -0.65, p < 0.001) but only in women. CONCLUSION: We conclude that hemodialysis patients have a marked decreased in cortical density, thickness, and area with significant reduction in trabecular parameters that correlated with the severity of secondary hyperparathyroidism only in women. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/22234812/Evaluation_of_bone_microarchitecture_by_high_resolution_peripheral_quantitative_computed_tomography__HR_pQCT__in_hemodialysis_patients_ L2 - https://dx.doi.org/10.1007/s00198-011-1890-9 DB - PRIME DP - Unbound Medicine ER -