Assessment of bone mineral density by dual-energy Xray absorptiometry in hemodialysis patients

Introduction. Chronic renal failure (CRF) is a common pathology that causes early disturbance of phosphate and calcium metabolism, leading to secondary hyperparathyroidism, affecting bone and mineral metabolism, and bone loss is common and silent. It is characterized by osteopenia, deterioration of bone quality, and altered bone structure. Our work aims to determine bone status by examining the clinical, biological characteristics and bone mineral density (BMD) of hemodialysis patients at Constantine Regional Military University Hospital (CRMUH). Methods. This was a prospective study involving all CRMUH hemodialysis patients. Biological assessment assesses bone damage and the elements used in current practice (calcemia, phosphate and parathyroid hormone) and two-photon absorptiometry (DXA) assesses BMD. Results. This study involved 18 male and female patients with a sex ratio of 1 and a mean age of 50.94 ± 17.46 years who received hemodialysis for a mean treatment duration of 8.72 years. Hypocalcemia accounted for 44.4%, hyperphosphatemia accounted for 61.1%, and hyperparathyroidism accounted for 50% of patients. The mean BMD for our entire population was 0.871 ± 0.174 g/cm² in the lumbar spine and 0.679 ± 0.099 g/cm² in the left hip. Mean T-scores were -1.628 ± 1.197 SD for the lumbar spine and -1.861 ± 0.622 DS for the left hip. We found 33.3% of osteoporosis (83.3% trabecular osteoporosis) and 66.7% of osteopenia, including 83.3% cortical osteopenia. Multivariate analysis identified 3 risk factors for osteoporosis in a statistically significant manner, namely, duration of hemodialysis greater than 10 years, hypocalcemia, and hyperparathyroidism greater than 500 Pg/ml. Conclusions. Disturbed calcium phosphate metabolism and its skeletal consequences are certain and common complications in hemodialysis patients. It has a greater effect on cortical bone. Early detection and preventive measures are necessary.