Dialysis Vintage, Vitamin D, and Bone Mineral Density of CKD Patients on Chronic Hemodialysis

Abstract

Background: Bone mineral disorders in chronic kidney disease (CKD-MBD) is one of the complications that occurs due to systemic disorders of minerals and bones in chronic kidney disease (CKD). This syndrome is one or a combination of laboratory abnormalities (phosphate, parathyroid hormone, and vitamin D), bone disorders (turnover, mineralization, volume, linear growth, and strength), and/ or vascular calcification or other soft tissue. It is associated with high mortality and morbidity in CKD patients. To determine the relationship of vitamin D levels and bone mineral density (BMD) examination with the hemodialysis vintage in CKD patients undergoing hemodialysis at RSUD Dr. Zainoel Abidin. Methods: This study is a cross-sectional study held in Zainoel Abidin Hospital, Banda Aceh, Indonesia, from January until May 2017. We include all patients who received twice-weekly hemodialysis for at least 3 months. Patients who received corticosteroids in the past 2 weeks, pregnant, suffering from endocrine disorders or malignancy, autoimmune diseases, and thalassemia, and menopausal women, were excluded. Laboratory examination and Bone Densitometry were performed before a single hemodialysis session. Data were analyzed using the Spearman Rank Correlation test. Results: Thirty patients were analyzed from 196 hemodialysis patients. The proportion of patients that have vitamin D insufficiency was 56.6%. The proportion of patients that have with normal vitamin D was 43.3%. The proportion of patients that have osteoporosis was 30% and 56.6% were osteopenia based on bone densitometry examination. The magnitude of the Spearman Rank Correlation coefficient between vitamin D levels and the duration of hemodialysis in CKD patients is-0.552 with a p-value

Tỉ lệ giảm Vitamin D huyết thanh và mối liên quan với mật độ xương ở bệnh nhân bệnh thận mạn có độ lọc cầu thận ước tính dưới 60 ml/phút tại Bệnh viện Trưng Vương

“…Tác giả kết luận, thiếu hụt vitamin D có thể góp phần làm suy giảm sức mạnh xương của bệnh nhân lọc máu [16]. Nghiên cứu năm 2020 của Maimun Syukri cũng cho thấy có mối tương quan giữa quá trình chạy thận nhân tạo với nồng độ vitamin D và mật độ xương [17]. Valkovsky cũng cho kết quả tương tự, tỉ lệ thiếu 25(OH) vitamin D là 96% và có giảm mật độ xương ở bệnh nhân đang chạy thận nhân tạo [18].…”