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  • Title: Bone mineral density in end-stage renal disease patients: association with wasting, cardiovascular disease and mortality.
    Author: Matsubara K, Suliman ME, Qureshi AR, Axelsson J, Martola L, Heimbürger O, Barany P, Stenvinkel P, Lindholm B.
    Journal: Blood Purif; 2008; 26(3):284-90. PubMed ID: 18421213.
    Abstract:
    BACKGROUND: Bone and mineral disorders may contribute to extraosseous ossifications and cardiovascular disease (CVD) in end-stage renal disease (ESRD) patients. We have investigated the relationship between bone mineral density (BMD) and inflammation, wasting, CVD and mortality in ESRD patients. METHODS: BMD (dual energy X-ray absorptiometry) and biochemical, nutritional and inflammatory markers were assessed in 277 incident ESRD patients (GFR 7.1 +/- 0.2 ml/min) who were then followed prospectively for a mean of 27 (range 1-60) months. Carotid plaques were determined in 103 patients. RESULTS: Patients with carotid plaques, clinical manifestation of CVD and wasting (assessed by subjective global assessment) had significantly lower BMD than their counterparts. Low BMD was associated with high all-cause and cardiovascular mortality. Even after adjustment for several confounders and risk factors, all-cause (HR = 2.1, CI: 1.1-3.9, p = 0.02) and cardiovascular (HR = 2.8, CI: 1.2-6.3, p = 0.02) mortality remained significantly associated with low BMD. CONCLUSIONS: Low BMD is associated with wasting and CVD, and is an independent predictor of all-cause and cardiovascular mortality in ESRD patients.
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