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Abstract: TH-PO159

Is the Discordance Between Spine and Hip Bone Mineral Density in Patients on Dialysis by Vascular Calcification?

Session Information

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Kang, Donghyuk, Catholic University of Korea Bucheon Saint Mary's Hospital, Bucheon, Korea (the Republic of)
  • Kwon, Young-Joo, Korea University College of Medicine, Seoul, Korea (the Republic of)
Background

End-stage kidney disease (ESKD) patients with long-standing maintenance dialysis had at greater risk of developing vascular calcification, osteoporosis and cardiovascular disease. In general population, many studies had undergone to identify the association between vascular calcification and bone mineral density (BMD). However, the pathophysiology of vascular calcification in dialysis patients is different from general population, and the study evaluating relationship of vascular calcification with bone mineral density is scarce. In addition, it is not well-known that which bone is more affected to vascular calcification. Therefore, we aimed to evaluate the association between BMD and vascular calcification in patients with maintenance dialysis

Methods

In this multicenter, prospective, observational study of ESKD patient, 576 patients with older than 50 years old or menopausal state of women were analyzed. Vascular calcification was measured by Kaupplia score and BMD of lumbar spine and hip was measured by dual-energy X-ray absorptiometry. Using T-scores, association of vascular calcification with each site of BMD (femur, spine, and lowest score of either femur or spine) was evaluated. Additional analysis with discordance between hip and spine BMD was also performed.

Results

Among 268 (46.5%) women patients, 242 (90.3%) were menopausal state. Median age of study participants was 63.0 (57.0-70.0) years. Spine BMD showed negative correlation with vascular calcification (R=0.1, P=0.014), but hip and lowest score of both BMD were not significant (R=-0.051, P=0.02; R=-0.029, P=0.49, respectively). 282 (52%) patients were concordance between hip and spine BMD, and correlation was not significant in all the hip, spine, and lowest score of both BMD (R=0.0034, P=0.95; R=0.073, P=0.22; R=0.0037, P=0.95, respectively). In discordance group, spine BMD was also negatively correlated (R=0.19, P=0.0023) and hip BMD was positively correlated (R=-0.12, P=0.053), with more prominent in low BMD of less than -2.5 (R=-0.22, P=0.048).

Conclusion

In dialysis patients with discordance BMD, vascular calcification is positively associated with hip BMD (especially in low BMD of less than -2.5) and negatively associated with spine BMD.