Aim: We studied in a hemodialysis (HD) population the correlations between bone metabolism markers measured by DEXA compared with other bone markers: serum calcium, serum phosphate, serum iPTH level and the inflammatory status, known as high risk for morbidity in HD patients which has not been studied yet.
Method: Twenty-seven patients from a hemodialysis unit were included in the study. The following parameters were measured: serum calcium (Ca), serum phosphate (P), total alkaline phosphatase (AP), intact parathormon level (iPTH) as bone metabolism markers and fibrinogen and C reactive protein (CRP) as inflammatory markers. Osteodensitometry was measured with DEXA technique and T-score was recorded. Statistical data were analyzed with the program Excel 2007 and mean, SD, Pearson’s correlation coefficient r and χ2-test were calculated.
Results: Significant correlations were found between serum Ca levels and P (p=0.002), AP (p=0.002) and T-score (p=0.0003). Also there was a correlation between CRP and phosphate (p=0.029) and CRP and fibrinogen (p=0.037). Calculating the correlation coefficient r, the significant correlation threshold was relevant to Ca and AP (r=0.33, p <0.05), Ca and BMD (r=0.31, p <0.05), P and BMD (0.30, p <0.05), P and fibrinogen (r=0.6, p <0.01).
Conclusions: In HD patients, CRP is correlated with bone metabolism, in the absence of infection. Serum phosphate is the only marker correlated
with bone markers, inflammatory markers and T-score for osteodystrophy, being an important tool for the future prognostic of these patients.
Mineral Bone Disorder in Hemodialysis Patients – a New Face of an Old Concept
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