ISSN:
1433-2965
Keywords:
Key words:Bone geometry – Cortical bone density – Hemodialysis – pQCT – PTH excess – Uremic patients
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract: The aim of this study was to establish, by means of peripheral quantitative computed tomography (pQCT) at the distal radius, the existence of cortical and/or trabecular osteopenia, and to assess the integrity of bone geometry in uremic patients undergoing maintenance hemodialysis. Our results show a clearcut selective reduction in volumetric cortical density, more evident in women (p=–0.0001) than men (p= 0.030), which appears to be independent of age and menopausal status. Trabecular density was not significantly changed in either sex. Cortical density of the patients correlated inversely with age (p = 0.003), duration of dialysis (p= 0.002) and parathyroid hormone (PTH) levels (p= 0.03). Trabecular density correlated only with age. Normally, cortical density is age-dependent and its reduction is accompanied by compensatory geometry changes. Compared with control subjects, in our female patients both cortical area and cortical thickness were reduced (p= 0.02 and 0.008), while cross-sectional area did not change (p= 0.67). Conversely, in the males only cross-sectional area was reduced (p= 0.02). In conclusion, in uremic patients we observed a selective cortical osteopenia, more evident in the female sex, and a sex-specific pattern of geometry impairment, with resultant apparent increased bone fragility in the uremic women. We suggest that the prolonged PTH excess could be responsible, directly and/or interacting with estrogen deficiency.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/s001980050089
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