Kidney Week

Abstract: TH-PO574

Usefulness of Trabecular Bone Score and Central Quantitative CT for Assessment of Bone in CKD Patients

Session Information

• Bone and Mineral Metabolism: Bone Disease
  November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

• 402 Bone and Mineral Metabolism: Clinical

Authors

• Kim, Keunyoung, Pusan National University Hospital, Pusan, Korea (the Republic of)

Keunyoung Kim,

• Kim, Injoo, Pusan National University Hospital, Pusan, Korea (the Republic of)

Injoo Kim,

• Pak, Kyoungjune, Pusan National University Hospital, Pusan, Korea (the Republic of)

Kyoungjune Pak,

• Kim, Seong-jang, Pusan National University Hospital, Pusan, Korea (the Republic of)

Seong-jang Kim,

• Choi, Su Jung, Pusan National University Hospital, Pusan, Korea (the Republic of)

Su Jung Choi,

• Jeon, Yunkyung, Pusan National University Hospital, Pusan, Korea (the Republic of)

Yunkyung Jeon,

• Kim, Sang soo, Pusan National University Hospital, Pusan, Korea (the Republic of)

Sang soo Kim,

• Seong, Eun Young, Pusan National University Hospital, Pusan, Korea (the Republic of)

Eun Young Seong,

• Song, Sang Heon, Pusan National University Hospital, Pusan, Korea (the Republic of)

Sang Heon Song,

Background

The aims of this study are to propose the usefulness of central quantitative computed tomography(cQCT) and trabecular bone score(TBS) in bone assessment and to show the characteristics of diagnostic discordances in patients with chronic kidney disease(CKD) compared with healthy control.

Methods

This retrospective study included 135 patients (M : F, 73 : 62) with CKD that bone mineral density (BMD) was checked with both cQCT and dual energy absorptiometry (DXA) at the lumbar spine (LS) and femur neck (FN) area. Healthy control included 380 participants who visited hospital of a health check-up (M : F, 170 : 210). The discordancy refers to the diagnostic difference between two sites of DXA or between two modalities of DXA and cQCT. TBS was calculated from DXA images. The volume of abdominal aortic calcification (AAC) was measured using HU threshold (above 130HU) of CT images for cQCT. We classified bone state into three categories such as normal BMD, osteopenia and osteoporosis.

Results

The diagnosis rate for osteoporosis using T-score of FN was not significant different between two groups. Using T-score from only LS, osteoporosis was less common in CKD group compared with control (6.7% vs. 11.8%, P = 0.024). In CKD patients, the results of cQCT showed more osteopenia or osteoporosis among subjects with normal BMD in LS of DXA: osteopenia (n = 49, 31.9 %), osteoporosis (n = 12, 8.9%). Also, CKD patients had significantly lower value of TBS than control group within the same diagnostic category based on DXA (Figure 1). Furthermore, evaluating the discordancy between FN and LS in DXA, the rate of higher BMD of LS was more common than that of FN in CKD patients (85.7% vs. 14.3%; P < 0.001) compared with control group (49.4% vs. 50.6%). The volume of AAC has significant positive correlation with BMD from cQCT (r = -0.188, P = 0.031) whereas that showed negative correlation with BMD from DXA (r = 0.046, P = 0.456, Figure 2).

Conclusion

TBS and cQCT should be proper diagnostic method for the accurate assessment of bone in CKD patients because DXA may overestimate LS BMD. Probably, the AAC would contribute to increase the unexpected increase of LS BMD unlike actual bone status.