Saeid Amirkhanlou
1 
, Gholamreza Roshandel
2 , Mehrdad Aghaei
3, Hossein Mohebi
4, Sahab-Sadat Tabatabei
5, Shiva Momen
6, Peyman Zia
7, Mehdi Aarabi
8,9, Farzad Amouzadeh
10, Seyyed-Mohsen Hosseininejad
11,9* 1 Department of Nephrology, Clinical Research Development Unit, Sayad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
2 Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
3 Joint, Bone, Connective tissue, Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran
4 Department of Orthopedic Surgery, Kermanshah University of Medical Sciences, Kermanshah, Iran
5 Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
6 Student Research Committee, School of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
7 Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
8 Department of Orthopedic Surgery, Toronto East General Hospital, University Health Network, Toronto, Ontario, Canada
9 Joint, Bone, Connective tissue, Rheumatology Research Center (JBCRC), Golestan University of Medical Sciences, Gorgan, Iran
10 Emem-Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
11 Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
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 ± SD 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 HD 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.