BONE-MINERAL CONTENT IN PATIENTS ON PROLONGED MAINTENANCE HEMODIALYSIS - A 3-YEAR FOLLOW-UP-STUDY

  • 1 January 1983
    • journal article
    • research article
    • Vol. 20  (6) , 302-307
Abstract
Bone mineral content (BMC) was measured annually over a 3-yr period in 31 consecutive patients on maintenance hemodialysis (HD). No patient had received treatment with vitamin D derivatives, anticonvulsants or corticosteroids, nephrectomy or a renal transplant. Initial median BMC value in percent of sex and age matched normal mean was significantly decreased to 91.0% (P < 0.01), indicating bone mineral loss in chronic renal failure prior to HD. During HD a highly significant fall in mean BMC (in percent of initial value) continued to 95.1%, 92.7% and 90.8% after 1, 2 and 3 yr, respectively, with no influence of age, sex or initial BMC value. The interindividual variation in BMC changes, however, was considerable: the BMC loss over 3 yr exceeded 10% in 13 (42%) patients (rapid losers) while 12 (39%) patients had a BMC loss < 5%, or no loss at all. The rapid loser group had significantly higher serum levels of parathyroid and Ca X P product than the other group of patients (P < 0.02) in patients with chronic pyelonephritis (9.8%) and polycystic kidney disease (14.2%), but much smaller, and not significant, in patients with chronic glomerulonephritis (4.8%). A selection of patients with a high degree of bone mineral loss during HD is not possible by means of sex, age, initial BMC, biochemical parameters, or diagnosis (2 patients with chronic glomerulonephritis appeared to be rapid losers). For that purpose a high-precision BMC method is mandatory.