Abstract: FR-PO0249
Quantitative Bone Ultrasonography in Patients on Dialysis Predicts Mortality: A Five-Year Cohort Study
Session Information
- Bone and Mineral Metabolism: Clinical Epidemiology and Outcomes
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Bone and Mineral Metabolism
- 502 Bone and Mineral Metabolism: Clinical
Authors
- Cohen-Hagai, Keren, Meir Medical Center, Kefar Sava, Center District, Israel
- Kalantar-Zadeh, Kamyar, The Lundquist Institute, Torrance, California, United States
- Arbib, Nissim, Meir Medical Center, Kefar Sava, Center District, Israel
- Einbinder, Yael, Meir Medical Center, Kefar Sava, Center District, Israel
- Nacasch, Naomi, Meir Medical Center, Kefar Sava, Center District, Israel
Background
Bone disease is prevalent among dialysis patients and is associated with a higher risk of fractures and greater morbidity and mortality
Quantitative Ultrasound(QUS) is a novel,non-invasive technique that uses high-frequency sound waves to assess bone properties.Its use in dialysis remains underexplored
Methods
QUS was performed in maintenance dialysis patients at a single time point(July2020),during which baseline data were also collected. Approximately 5years after the QUS assessment,we evaluated patient outcomes in terms of mortality and fracture incidence
Results
The study included 91 patients (mean age 71±17years).Based on QUS-measured Speed of Sound(mean 3,798±200m/s), patients were divided into low(<3,800,n=45) and high(≥3,800,n=46) SOS groups, reflecting lower and higher bone density, respectively.
No significant differences were observed between the groups across age, dialysis vintage, or BMI. However, the low SOS group had a higher proportion of female patients and exhibited elevated markers of hyperparathyroidism and inflammation. SOS was inversely correlated with ALP(r=–0.3, P =0.004), phosphorus(r=–0.2, P=0.02) and PTH(r=–0.3, P=0.008).
Over a 5-year follow-up, 20 fractures were documented, evenly distributed between the groups (n=10 each, P=0.96). In a multivariable Cox proportional hazards model that included age,sex,dialysis vintage, BMI, diabetes and SOS as covariates, none of the variables were independently associated with fracture.
Mortality was significantly higher in the low SOS group compared to the high SOS group(75.6%vs 41.3%,P=0.001). After adjustment for , age and sex, HR for mortality in the low SOS group was 1.8(95%CI1.0–3.3,P=0.05)
Conclusion
These findings underscore the complexity of bone disease in dialysis patients.While SOS was not associated with fracture risk,its association with higher mortality suggests it may serve as a marker of underlying systemic processes,such as inflammation and vascular calcification, beyond bone quality alone
Cox model