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: PO0597

Significant Associations Between Vascular Calcification and Bone Mineral Density in CKD

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Uhlinova, Jana, Tartu Ulikool Arstiteaduskond, Tartu, Tartumaa, Estonia
  • Kuudeberg, Anne, Tartu Ulikool, Tartu, Tartumaa, Estonia
  • Lember, Margus, Tartu Ulikool Arstiteaduskond, Tartu, Tartumaa, Estonia
  • Ots-Rosenberg, Mai, Tartu Ulikool Arstiteaduskond, Tartu, Tartumaa, Estonia
Background

Vascular calcification (VC) demonstrated as a predictor of cardiovascular mortality in chronic kidney disease (CKD) patients (pts). There are uncertainties in term of factors that may explain the links between low bone mineral density (BMD) and mortality in CKD. We aimed to study associations between VC and BMD in CKD pts.

Methods

We studied 90 consecutive CKD pts. The following VC assessments used: 1) lateral lumbar X-rays and the scoring system to assess VC of the abdominal aorta using a semi-quantitative scoring (Kauppila,1997); 2) Ankle-brachial index (ABI) assessment (Winsor,1950). A simple, non-invasive, accurate tool to evaluate arterial stiffness and peripheral arterial disease providing diagnostic and prognostic information with values ≥1.3 or〈0.9 (Gu,2019); 3) Echocardiography; 3) BMD assessed by total body dual-energy X-ray absorptiometry (DXA).

Results

Study group pts (N=90, 41% male) median age was 64 years. Diabetes mellitus and hypertension were the common causes of CKD (29% and 28%, respectively). Kauppila score 〉1 detected in 41% of cases. The evidence of peripheral VC measured by ABI detected in 23% of causes. The heart valves calcinosis and fibrosis found in 41% of pts. Table demonstrates multivariate regression analysis with variables entering the equation as correlates of DXA measurements with Kauppila score and ABI as dependent variables. In pts with heart valves lesions total body BMD is significantly lower than in those who have normal heart valves. In factorial regression analysis BMD of femur, femur neck and total body BMD were significantly associated with heart valves calcinosis/fibrosis. BMD of femur and femur neck also inversely associated with age.

Conclusion

BMD associated with VC in pts with different CKD stages. Multi-interventional approach for diagnosis of CKD-BMD is necessary for early detection to prevent complications. Total body DXA is more informative in clinical practice for evaluation of BMD.

 R2Coefficient95% CIp-value
Kauppila score0.53   
BMD femur neck -33.5-49.1 - -17.70.001
BMD total spine -25.1-40.1 - -10.00.001
ABI0.39   
BMD femur neck -2.21-3.09 - -1.330.001
BMD spine L1-L4 -0.77-1.33 - -0.210.01
BMD ribs -1.69-2.74 - -0.650.002

Funding

  • Government Support – Non-U.S.