Kidney Week

Abstract: FR-PO0244

Risk Factors for Bone Mineral Density Decline in CKD

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

• Jeon, Hyejin, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hyejin Jeon, MD

• Lee, Seunghye, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Seunghye Lee, MD

• Jung, Sehyun, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Sehyun Jung, MD

• Jang, Hani, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hani Jang, MD, PhD

• Kim, Jin Hyun, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Jin Hyun Kim

• Kim, Hyun-Jung, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Hyun-Jung Kim, MD, PhD

• Chang, Se-Ho, Gyeongsang National University Hospital, Jinju-si, Gyeongsangnam-do, Korea (the Republic of)

Se-Ho Chang, MD, PhD

Background

Bone mineral density (BMD) loss and osteoporosis are common complications in chronic kidney disease (CKD), increasing the risk of fractures and adverse outcomes. While bone loss in CKD involves complex mechanisms such as mineral metabolism disorders and sarcopenia, the impact of muscle mass and body composition remains unclear. This study aimed to identify clinical and biochemical factors associated with BMD decline and osteoporosis in CKD patients.

Methods

This retrospective, single-center cohort study included CKD patients who underwent at least two BMD assessments. Patients were classified into two groups: the stable group (normal or improved BMD) and the progressive group (BMD deterioration or diagnosed osteoporosis at final assessment). Clinical characteristics, body composition, and laboratory data were compared, and logistic regression analysis was performed to identify independent risk factors. Low muscle mass was defined using sex-specific skeletal muscle index (SMI) cut-off values (<9.22 kg/m² for males, <8.01 kg/m² for females) based on ROC analysis.

Results

A total of 352 patients were included, with 295 (83.8%) in the stable group and 57 (16.2%) in the progressive group. Patients in the progressive group were older (p=0.002) and had a higher proportion of females (66.7%, p=0.001) compared to those in the stable group. Body mass index (BMI), SMI, and body fat mass were significantly lower in the progressive group (all p<0.001). The prevalence of low muscle mass was also higher in this group (p<0.001). The mean level of intact parathyroid hormone was significantly higher (p=0.001). In multivariate logistic regression analysis, age ≥70 years (odds ratio [OR], 2.48 p=0.008), female sex (OR, 2.27; p=0.016), low muscle mass (OR, 2.54; p=0.004), and hyperparathyroidism (OR, 2.91; p=0.018) were independently associated with BMD decline and osteoporosis.

Conclusion

In CKD patients, older age, female sex, low muscle mass, and hyperparathyroidism were independent risk factors for BMD decline and osteoporosis. These findings emphasize the importance of early detection and management of sarcopenia and mineral metabolism disorders to protect bone health. Further large-scale studies are needed to validate these results.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025qedgfyq4