ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO570

Increase in Fat Mass Has Protective Effect on Bone Mineral Density Loss After Initiation of Dialysis Therapy

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Iseri, Ken, Karolinska Institutet, Stockholm, Sweden
  • Qureshi, Abdul Rashid Tony, Karolinska Institutet, Stockholm, Sweden
  • Li, Xin, Karolinska Institutet, Stockholm, Sweden
  • Dai, Lu, Karolinska Institutet, Stockholm, Sweden
  • Heimburger, Olof, Karolinska Institutet, Stockholm, Sweden
  • Barany, Peter F., Karolinska Institutet, Stockholm, Sweden
  • Lindholm, Bengt, Karolinska Institutet, Stockholm, Sweden
  • Stenvinkel, Peter, Karolinska Institutet, Stockholm, Sweden
Background

In contrast to general population, increased fat mass (FM) was reported to have a beneficial effect on mortality risk in dialysis patients. However, the effect of FM on bone status is unclear. We investigated the association between bone loss after initiation of dialysis and changes of fat mass during 1-year of dialysis therapy.

Methods

246 patients initiating hemodialysis (HD; n=105) or peritoneal dialysis (PD; n=141) were investigated at initiation of dialysis and after 1 year on dialysis. Measurements included: whole body dual-energy X-ray absorptiometry (DXA) for assessment of bone mineral density (BMD) and body composition; nutritional status by subjective global assessment (SGA) and handgrip strength as percentage of controls (HGS%); and, various biochemical biomarkers including insulin growth factor-1 (IGF-1).

Results

During 1-year of dialysis therapy, T- and Z-scores decreased significantly compared to baseline (both p<0.05). Whereas there was no statistically significant change in body weight during 1-year dialysis therapy, total FM, trunk FM and peripheral FM increased significantly compared to start of dialysis, while lean body mass (LBM) decreased. In multivariate linear mixed model, changes of total FM, trunk FM, peripheral FM and LBM were positively associated (all p<0.05) with changes of BMD at all sites except head after adjusting for several confounders (sex, age, height, smoking, physical activity, SGA, HGS%, parathyroid hormone and dialysis modality. Furthermore, changes of serum IGF-1 levels were positively associated with changes of total FM, trunk FM and peripheral FM (p<0.05), but not LBM.

Conclusion

An increased fat mass, central as well as peripheral, appears to have a protective effect on bone loss 1 year after initiation of dialysis. We speculate that the observed effect - which might be one contributor to the beneficial effect of FM on mortality risk in dialysis patients - could be partially explained by enhancement of IGF-1.

Funding

  • Commercial Support