Low Bone Volume—A Risk Factor for Coronary Calcifications in Hemodialysis Patients

• Published in: Clinical journal of the American Society of Nephrology Vol. 4; no. 2; pp. 450 - 455
• Main Authors: Adragao, Teresa, Herberth, Johann, Monier-Faugere, Marie-Claude, Branscum, Adam J, Ferreira, Anibal, Frazao, Joao M, Dias Curto, Jose, Malluche, Hartmut H
• Format: Journal Article
• Language: English
• Published: United States American Society of Nephrology 01.02.2009
• Subjects: Adult; Age Factors; Aged; Biopsy; Bone Remodeling; Calcinosis - etiology; Calcinosis - pathology; Calcinosis - physiopathology; Chronic Disease; Coronary Artery Disease - etiology; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Cross-Sectional Studies; Female; Humans; Ilium - diagnostic imaging; Ilium - pathology; Ilium - physiopathology; Kidney Diseases - complications; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidney Diseases - therapy; Male; Middle Aged; Mineral Metabolism and Bone Disease; Odds Ratio; Organ Size; Renal Dialysis - adverse effects; Risk Assessment; Risk Factors; Severity of Illness Index; Tomography, X-Ray Computed; Young Adult
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/CJN.01870408

There is increasing evidence that altered bone metabolism is associated with cardiovascular calcifications in patients with stage 5 chronic kidney disease on hemodialysis (HD). This study was conducted to evaluate the association between bone volume, turnover, and coronary calcifications in HD patients. In a cross-sectional study, bone biopsies and multislice computed tomography were performed in 38 HD patients. Bone volume/total volume, activation frequency, and bone formation rate/bone surface were determined by histomorphometry and coronary calcifications were quantified by Agatston scores. Prevalence of low bone turnover was 50% and of low bone volume was 16%. Among the studied traditional cardiovascular risk factors, only age was found to be associated with coronary calcifications. Lower bone volume was a significant risk factor for coronary calcifications during early years of HD, whereas this effect was not observed in patients with dialysis duration >6 yr. Histomorphometric parameters of bone turnover were not associated with coronary calcifications. Low bone volume is associated with increased coronary calcifications in patients on HD.