The Progression of Bone Mineral Density Loss in Dialysis Patients Compared with the General Population

Background/Aims: The aim of this study was to compare the progression of bone mass loss in chronic hemodialysis patients (CHPs) with that in general population patients (GPPs) over an 18-month period. Methods: The control group consisted of 60 patients (aged $57.5{\pm}10.9$ years) with a glomerular filtration rate > $60mL/min/1.73m^2$. The study group included 80 patients undergoing hemodialysis (aged $59.3{\pm}11.8$ years; duration of dialysis $5.47{\pm}5.16$ years). Bone mineral density (BMD) testing was conducted in both groups using dual energy X-ray absorptiometry at hip and lumbar spine regions at baseline and after 18 months. Biochemical parameters (albumin, C-reactive protein, calcium, ionized calcium, alkaline phosphatase, and parathyroid hormone) were determined in all participants using standard laboratory procedures. Results: The mean values of BMD (average hip + lumbar spine) were $0.900{\pm}0.14g/cm^2$ and $0.866{\pm}0.14g/cm^2$ in the GPP and $0.823{\pm}0.16g/cm^2$ and $0.769{\pm}0.13g/cm^2$ in the CHP groups at baseline and 18 months, respectively. The statistical significance (p value) of hip bone loss progression over 18 months was 0.0577 for GPP and 0.0002 for CHP, whereas that of lumbar spine bone loss progression was 0.6820 for GPP and 0.5389 for CHP. Conclusions: The of progression bone mass loss was significantly greater in CHP than in GPP. Bone mass loss was evident even over 1 month, albeit in only the CHP with accelerated osteoporosis.