TITLE:
Females Had a Worse T-Score at Lumbar Region and Males Had a Worse T-Score at Femoral Region among Chronic Kidney Disease
AUTHORS:
Hilal Al Kalbani, Issa Al Salmi, Fatma Al Rahbi, Sumaiya Al Siyabi, Suad Hannawi
KEYWORDS:
Bone-Mineral-Density-BMD, Dual-Energy X-Ray Absorptiometry-DEXA, Chronic-Kidney-Disease-CKD, T-Score, Lumbar Region, Femoral Region, Gender
JOURNAL NAME:
Open Journal of Nephrology,
Vol.12 No.1,
February
24,
2022
ABSTRACT: Background: To evaluate bone-mineral-density-BMD determined by dual-energy X-ray absorptiometry-DEXA and bone turnover markers in chronic-kidney-disease-CKD patients. Method: An observational-clinical study of all patients who were scanned by DEXA-scan in 2018. All patients with low-bone-density or osteoporosis-based on World-Health-Organization-WHO definition were included. Results: 505 patients with abnormal-BMD, 87.3% were in early-stage CKD-stage I - II, 8.5% were in CKD-stage III - V and 4.2% did not have renal tests. 95 (18.8%) were male with a mean age of 57.0 years and 410 (81.2%) were females with a mean age of 55.8 years. Patients of ≥65 years had lower T-score than those who were younger than 65 years-old. Among CKD patients, those with late-CKD (stage III - V) had less BMD-measurements and lower T-score than those with early-CKD (stage I - II). A significant positive correlation exists between parathyroid hormone-PTH-level and the lower T-score. Female had a worse T-score at the lumbar-region whereas male had a worse T-score at the femoral-region. There was no significant difference between males and females for the T-score at hip-region. Conclusion: We observed a distribution of abnormal BMD among different age, sex and CKD groups. Measurements of BMD by DEXA might be a useful test to diagnose osteoporosis in CKD patients. Femoral and total hip areas were more affected, however DEXA might not be able to detect osteoporosis in the lumbar area of CKD patients. T-scores are lower in patients with more severe CKD and lower in elderly patients. PTH level is associated proportionally to the degree of bone loss. Early intervention and proper management must be implemented early among CKD patients with multidisciplinary team approach strategy. More studies are needed to determine if DEXA techniques are enough to distinguish the quantity of bone loss between different stages of CKD.