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Abstract: SA-PO195

Mineral and Bone Disorder in Patients Living With the Human Immunodeficiency Virus on Hemodialysis: A Series of Cases

Session Information

Category: Bone and Mineral Metabolism

  • 402 Bone and Mineral Metabolism: Clinical

Authors

  • Vaz, Julia Braga, Hospital das Clinicas, Recife, Pernambuco, Brazil
  • Gueiros, Ana Paula, Hospital das Clinicas, Recife, Pernambuco, Brazil
  • Gueiros, Jose Edevanilson, Hospital das Clinicas, Recife, Pernambuco, Brazil
Background

The survival rate of patients living with the human immunodeficiency virus (HIV) has increased after the intensification of antiretroviral therapy. Decreased bone mineral density and fractures are reported in this population. Chronic kidney disease (CKD) causes mineral and bone disorder (CKD-MBD), which also contributes to low bone mineral density, fractures, and vascular calcification. This study aimed to assess the osteometabolic profile and the occurrence of vascular calcification in HIV patients undergoing hemodialysis.

Methods

The clinical and demographic data of 21 patients were assessed. Laboratory parameters were measured: total calcium, phosphorus, albumin, intact parathyroid hormone (iPTH), total alkaline phosphatase, 25OH-vitamin D, CD4 count and HIV viral load. Bone mineral density was assessed by bone densitometry, and x-rays of the pelvis, hands and abdomen were also taken to determine vascular calcification scores.

Results

The median age of patients was 48 years; 81% were male and the median times of HIV infection and hemodialysis were 132 and 120 months, respectively. Patients presented with hypertension (95%), heart disease (67%) and a history of smoking (85%). Median serum calcium and phosphorus levels were normal and the median iPTH was 360 pg/mL. Osteopenia was diagnosed in 33% of patients and osteoporosis in 33%. Around 24% of patients had previously suffered fractures. The Kauppila score was higher in patients with fractures (p=0.040). Vascular calcification was identified in 12 (57%) patients. Inverse correlations were demonstrated between the Kauppila score and the T-score of the femoral neck (p<0.001) and the T-score of the lumbar spine (p<0.001); and between the Adragão score and T-score of the femoral neck (p=0.001) and the T-score of the lumbar spine (p=0.001).

Conclusion

A high prevalence was observed of low bone mineral density, fractures and vascular calcification in HIV patients on hemodialysis. Our results corroborate the important relationship between bone metabolism and vessel. It is necessary to confirm these results with larger studies and preferably with a control group of non-HIV patients.