Bone density of the femoral neck in patients on maintenance dialysis

Nakanishi, Kazushige; Shishido, Kanji; Kumata, Chiaki; Ito, Katsuya; Nakashima, Yutaka; Wakasa, Mikio

doi:10.1371/journal.pone.0197965

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…However, although bone metabolism-related makers were not associated with BMD, SMI was independently associated with BMD. A previous study reported that the femoral neck BMD was affected by body weight and serum creatinine level, which could reflect muscle mass (19). Therefore, the maintenance of skeletal muscle might be important in preventing BMD.…”

Section: Discussionmentioning

confidence: 97%

Skeletal Muscle Mass Index Is Positively Associated With Bone Mineral Density in Hemodialysis Patients

Ookawara

Hibino³

et al. 2020

Front. Med.

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Background: Patients with chronic kidney disease (CKD) are at risk for bone loss and sarcopenia because of associated mineral and bone disorders (MBD), malnutrition, and chronic inflammation. Both osteoporosis and sarcopenia are associated with a poor prognosis; however, few studies have evaluated the relationship between muscle mass and bone mineral density (BMD) in hemodialysis (HD) patients. The present study examined the association between skeletal muscle mass index (SMI) and BMD in the lumbar spine and femoral neck in HD patients. Methods: Fifty HD patients (mean age, 69 ± 10 years; mean HD duration, 9.0 ± 8.8 years) in Minami-Uonuma City Hospital were evaluated. BMD was measured by dual-energy X-ray absorptiometry, and SMI was measured by bioelectrical impedance analysis (InBody TM) after HD. The factors affecting lumbar spine and femoral neck BMD were investigated, and multivariate analysis was performed. Results: In simple linear regression analysis, the factors that significantly affected the lumbar spine BMD were sex, presence of hypertension, presence of diabetes mellitus, body mass index, triglyceride level, grip strength, and SMI; the factors that significantly affected the femoral neck BMD were sex, HD duration, serum creatinine level, tartrate-resistant acid phosphatase 5b level, undercarboxylated osteocalcin (ucOC) level, N-terminal propeptide of type I procollagen level, grip strength, and SMI. In multivariate analysis, SMI (standardized coefficient: 0.578) was the only independent factor that affected the lumbar spine BMD; the independent factors that affected the femoral neck BMD were SMI (standardized coefficient: 0.468), ucOC (standardized coefficient: −0.366) and sex (standardized coefficient: 0.231).

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Section: Discussionmentioning

confidence: 97%

Skeletal Muscle Mass Index Is Positively Associated With Bone Mineral Density in Hemodialysis Patients

Ookawara

Hibino³

et al. 2020

Front. Med.

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“…We also analyzed each component of MetS and the associations with T-score, and found that abdominal obesity, hypertriglyceridemia, low HDL-C, and hyperglycemia were associated with T-score, whereas high blood pressure was not. Patients undergoing chronic dialysis have a lower BMD than healthy subjects of similar age due to CKD-related mineral and bone disorders [ 45 ]. Abdominal obesity can reflect higher mechanical loading on the bone, which then stimulates bone accrual [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between Metabolic Syndrome and Obesity-Related Indices and Bone Mineral Density T-Score in Hemodialysis Patients

Wung

Chung

et al. 2021

JPM

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Previous studies have reported inconsistent results regarding the associations between metabolic syndrome (MetS) and obesity-related indices and bone mineral density (BMD). However, no previous studies have reported these associations among hemodialysis (HD) patients. The aims of this study were to investigate associations between MetS and its components and BMD T-score in HD patients and also between obesity-related indices and BMD T-score in HD patients with and without MetS. MetS was defined according to the Adult Treatment Panel III for Asians, and BMD T-score was calculated using dual-energy X-ray absorptiometry. Eight obesity-related indices were evaluated, including lipid accumulation product (LAP), visceral adiposity index (VAI), body adiposity index, conicity index (CI), body roundness index (BRI), abdominal volume index (AVI), waist-to-height ratio (WHtR), waist–hip ratio, and body mass index (BMI). One hundred and sixty-four patients undergoing HD were enrolled, and the prevalence of MetS was 61.6%. MetS was significantly associated with high lumbar spine and total hip T-scores. Regarding the MetS components, abdominal obesity and low HDL-C were significantly associated with high lumbar spine, femoral neck, and total hip T-scores; hypertriglyceridemia was significantly associated with high lumbar spine and total hip T-scores; hyperglycemia was significantly associated with a high lumbar spine T-score, whereas high blood pressure was not associated with T-score at any site. In the patients with MetS, BMI, WHtR, AVI, and BRI were significantly associated with T-score at all sites, and high CI, VAI, and LAP were also related to a high lumbar T-score. However, these indices were not associated with T-score at any site in patients without MetS. This study demonstrated positive associations between MetS and its five components and BMD T-score among HD patients. MetS, abdominal obesity, hypertriglyceridemia, and low HDL-cholesterol were associated with low risk of osteoporosis among the HD patients. Furthermore, we found that some obesity-related indices were associated with BMD T-score among HD patients with MetS but not in those without MetS. Our study highlights the importance of BMI, WHtR, AVI, and BRI in predicting the risk of osteoporosis among HD patients with MetS. In clinical practice, they can be easily calculated through simple anthropometric measurements and routine laboratory examinations and be used to quickly and conveniently assess the risk of osteoporosis among HD patients.

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“…Similarly, feelings of shame, low self-esteem and stress caused by negative perceptions of body image may lead to eating disorders with further detriment to QOL (McDermott et al 2015). Bone mineral density in dialysis-dependent patients is also significantly lower than for the general population, and in younger patients, this frailty could be a serious hindrance to pursuing their personal aspirations (Nakanishi et al 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Conditions that dialysis patients may suffer from are: osteoarthritis, fractures and osteonecrosis, which may in some cases result in total knee replacement surgery (Nakanishi et al 2018;Ottesen et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Perceived predictors of quality of life in patients with end-stage renal disease on dialysis

Mbeje

Mtshali

2021

Curationis

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Background: Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South Africa are cared for in public and private hospitals, with public health institutions characterised by several challenges.Objective: To explore and analyse the perceived predictors of QOL in patients with ESRD in the three district hospitals that provide renal services in KwaZulu-Natal.Methods: An exploratory, descriptive qualitative research approach based on grounded theory research design was used and three focus group discussions (FGDs) were conducted. The researcher recruited 18 participants, 6 in each focus group. Three phases of data analysis were followed: open coding, axial coding, and selective coding.Results: Predictors of QOL that emerged were the geographic location of the patients, accessibility of haemodialysis centres, patients’ adaptation and acceptance of the condition, self-management, support by family members and caregivers and availability of adequately trained nurses.Conclusion: Predictors of QOL in patients with ESRD are associated with an increased risk of morbidity and mortality resulting from dialysis. The broad range of dimensions of life is negatively affected and requires intervention by the renal team and policymakers to improve the QOL of patients.

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Bone density of the femoral neck in patients on maintenance dialysis

Cited by 9 publications

References 23 publications

Skeletal Muscle Mass Index Is Positively Associated With Bone Mineral Density in Hemodialysis Patients

Skeletal Muscle Mass Index Is Positively Associated With Bone Mineral Density in Hemodialysis Patients

Associations between Metabolic Syndrome and Obesity-Related Indices and Bone Mineral Density T-Score in Hemodialysis Patients

Perceived predictors of quality of life in patients with end-stage renal disease on dialysis

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