Bone mineral density abnormalities in end stage chronic kidney disease patients in Pakistan

Résumé fourni par la source

To determine the proportion of CKD patients with osteopenia and osteoporosis in Pakistan. A prospective cross-sectional observational study, reported according to the STROBE guideline, was conducted among CKD stage-5 patients undergoing treatment and dialysis at three tertiary care hospitals in Pakistan. The sample size was calculated using Epi Info StatCalc. Demographic, clinical, laboratory, medication-related, and BMD data were collected using standardized data collection forms. Vitamin D levels and routine biochemical parameters were assessed, and BMD was measured using DXA at the lumbar spine site. Multivariable binary logistic regression was performed to identify predictors of BMD outcomes. A total of 412 CKD stage-5 patients were included in the study. The mean age of participants was 46.98 ± 11.87 years, and 63.1% were male. The proportion of patients with osteopenia and osteoporosis was 41.0% (95% CI: 36.3%–45.8%) and 26.5% (95% CI: 22.5%–31.0%), respectively. Significant associations were observed between BMD abnormalities and age, vitamin D status, calcium levels, phosphate levels, and dialysis-related variables ( p < 0.05). Multivariable regression analysis demonstrated that relatively higher eGFR within this stage-5 CKD cohort and higher vitamin D levels were independently associated with favorable BMD outcomes. Osteopenia and osteoporosis were observed in a high proportion of CKD stage-5 patients and are strongly associated with disturbances in mineral metabolism and vitamin D status. Regular bone health assessment and appropriate management of CKD-related mineral and bone disorders may help improve skeletal outcomes in this population.

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