1. The prevalence of osteoporosis is high in patients undergoing peritoneal dialysis but is not correlated with vitamin D levels.
Level of evidence: 3 (average)
One of the complications in patients with chronic kidney disease (CKD) is increased bone turnover and decreased bone mineral density. Bone mineral density (BMD) indicates bone mass and bone mineral content. It is measured using dual-energy x-ray absorptiometry (DEXA) scans at both the posteroanterior lumbar spine (L1-L4) and the hip (femoral neck or entire proximal femur). Previous meta-analyses highlighted a significant association between CKD and low BMD increasing fracture risk. Currently, there is conflicting evidence regarding DEXA scan measurements and biochemical markers of osteopenia and osteoporosis. In this cross-sectional study, researchers aimed to determine the prevalence in patients undergoing peritoneal dialysis (PD) and to correlate related biochemical variables. Patients undergoing PD were evaluated for clinical characteristics, biochemical markers, and BMD. A vitamin D survey showed that 86.8% of participants were deficient, with a median value of 8.7 ng/mL. BMD measurements revealed a 41% prevalence of osteoporosis at the femoral neck and 38% at the lumbar spine. Multivariate analysis examining the correlation between 25-vitamin D levels and BMD did not show a significant correlation. However, another multivariate analysis showed that BMI was positively correlated with BMD at both the femoral neck and lumbar spine. Clinical and biochemical markers of osteoporosis need to be further investigated to promptly initiate osteoporosis treatment in PD patients. Prophylactic vitamin D supplementation should be considered in PD patients.
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Image: PD
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