Muscular strength and bone mineral density in haemodialysis patients

Spindler, Alberto; Paz, Simone Patrícia Aranha da; Berman, Amir; Lucero, Eleonora; Contino, N; Peñalba, Adriana; Tirado, Silvia; Santana, Milana Drumond Ramos; Zeballos, Á. Chávez

doi:10.1093/ndt/12.1.128

Cited by 36 publications

(23 citation statements)

References 2 publications

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“…Patients who receive dialysis are weak compared with healthy sedentary control subjects (19,(61)(62)(63)(64)(65), and it is likely that weakness is an important limitation to physical functioning in patients with kidney disease. We previously showed that muscle strength was an important predictor of gait speed in patients who were on dialysis (19), and Diesel et al (66) showed that isokinetic muscle strength was an important determinant of VO 2peak in a group of patients who were on dialysis.…”

Section: Resistance Exercisementioning

confidence: 99%

Exercise in the End-Stage Renal Disease Population

Johansen¹

2007

Journal of the American Society of Nephrology

281

228

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Many of the known benefits of exercise in the general population are of particular relevance to the ESRD population. In addition, the poor physical functioning that is experienced by patients who are on dialysis is potentially addressable through exercise interventions. The study of exercise in the ESRD population dates back almost 30 yr, and numerous interventions, including aerobic training, resistance exercise training, and combined training programs, have reported beneficial effects. Recently, interventions during hemodialysis sessions have become more popular and have been shown to be safe. The risks of exercise in this population have not been rigorously studied, but there have been no reports of serious injury as a result of participation in an exercise training program. It is time that we incorporate exercise into the routine care of patients who are on dialysis, but identification of an optimal training regimen or regimens, according to patient characteristics or needs, is still needed to facilitate implementation of exercise programs.

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Section: Resistance Exercisementioning

confidence: 99%

Exercise in the End-Stage Renal Disease Population

Johansen¹

2007

Journal of the American Society of Nephrology

281

228

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“…However, when hemodialysis is started, the relationship between iPTH and low bone mass becomes complex (1,31,32). For this reason, study results are conflicting regarding the relationship between bone cycle determinators (alkaline phosphatase, calcium, phosphorous, iPTH) and BMD in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

The Osteoporotic Effect of Arteriovenous Fistula on the Ipsilateral Upper Extremity in Hemodialysis Patients

...

2012

Tftr

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Objective: Hemodialysis requires an arteriovenous fistula (AVF), the presence of which may influence the structure of nearby bone. This study analyzed the effect of AVF on ipsilateral upper extremity bone mineral density (BMD), as measured by phalangeal radiographic absorptiometry (RA). Materials and Methods:In this cross-sectional study, phalangeal BMD was measured in both arms by RA in a convenience sample of end-stage renal disease (ESRD) patients with a forearm AVF. Patients were excluded if the patient had pathology which might affect distal arm circulation. BMD values (g/cm 2 ) from forearms with AVF were compared with values from forearms without AVF. Predialysis values of complete blood count, calcium, phosphorus, alkaline phosphatase, parathyroid hormone, urea, creatinine, potassium, albumin, total cholesterol, HDL cholesterol, and LDL cholesterol were determined in all patients; dialysis adequacy values were also calculated. Results: One hundred and sixteen patients agreed to participate in the study. Thirty-three patients were excluded, thus, data were analyzed from 83 patients (59% male, 41% female, mean hemodialysis time: 156±6 months, mean age: 53±16 years). AVFs were located in the nondominant hand in all patients. Phalangeal BMD in forearms with AVF (0.28±0.05 g/cm 2 , range: 0.14-0.40) was significantly lower than that in the contralateral forearm (0.30±0.04 g/cm 2 , range: 0.19-0.40, p<0.05). Conclusion: In ESRD patients on hemodialysis, BMD is lower in the ipsilateral-to-AVF hand compared to the contralateral-to-AVF hand. In these patients, further investigations should be made to ascertain the ability of BMD assessment in determining fracture risk and to prompt physicians to initiate treatments which will preserve BMD and reduce fractures. Turk J Phys Med Rehab 2013;59:236-41. Key Words: Osteoporosis, bone mineral density, phalangeal radiographic absorptiometry, arteriovenous fistula Özet Amaç: Hemodiyaliz hastalarındaki arterio-venöz fistül (AVF), çevresindeki kemik dokunun yapısını etkileyebilir. Bu çalışmada falangial radyografik absorbsiyometri (RA) ölçümü ile AVF'nin ipsilateral üst ekstremite kemik mineral yoğunluğu (KMY) üzerine etkisi araştırılacaktır. Gereç ve Yöntem: Bu kesitsel çalışmada, ön kollarında AVF olan son dönem böbrek yetmezlikli hastaların (SDBY) falangial KMY değerleri her iki koldan RA ile ölçüldü. Distal kol dolaşımını etkileyebilecek herhangi bir patolojisi olan hastalar çalışma dışı bırakıldı. Fistüllü kol falangial KMY değerleri (g/ cm 2 ) fistülsüz kol falangial KMY değerleri (g/cm 2 ) ile karşılaştırıldı. Tüm hastalara diyaliz öncesi tam kan sayımı yapıldı, kalsiyum, fosfor, alkalen fosfataz, paratiroid hormon, üre, kreatinin, potasyum, albümin, total kolesterol, HDL kolesterol ve LDL kolesterol değerleri ölçüldü; diyaliz yeterliliği değerleri hesaplandı. Bulgular: Çalışmaya 116 hasta katıldı. Otuz üç hasta çalışma dışı bırakıldı, 83 hastanın sonuçları değerlendirildi. Hastaların %59'u erkek, %41'i kadın olup, hemodiyalize girme süreleri 156± 6 ay ve yaşları 53±...

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“…‹leri evre böbrek yetmezli¤i olan hastalarda kemik mineral metabolizmas›ndaki bozulma sonucu osteoporozun geliflimi önemli bir sa¤l›k sorunudur. Bu çal›flmada, bu konudaki çal›flmalar›n ço¤unlu¤unda oldu¤u gibi, hastalarda osteoporozun tan›s›na yönelik olarak DXA kullan›m› tercih edilmifltir (8)(9)(10)(11)(12)(13)(14)(15) Bu çal›flmada en az alt› ayd›r hemodiyaliz uygulanmakta olan hastalar›n femur boynu T-skorlar› lomber vertebralara göre belirgin olarak düflük bulundu. Dünya Sa¤l›k Örgütünün s›n›flamas›na göre lomber bölgede hastalar›n %60'›nda osteopeni, %7'sinde osteoporoz ve femur boynunda hastalar›n %40'›nda osteopeni, %50'sinde osteoporoz belirlendi.…”

Section: G Gi Ir Ri Ifl Flunclassified

“…Literatürde bizim çal›flmam›zda oldu¤u gibi KMY de¤erleri ile yafl ve diyaliz süresi aras›ndaki iliflkiyi aç›¤a ç›karama-yan baflka araflt›rmalar da bulunmaktad›r (8,11,(18)(19)(20). Bunun nedeni hasta say›s›n›n az olmas›n›n yan› s›ra yafl ve diyaliz sürele-ri de¤erlerinin genifl aral›¤a da¤›lm›fl olmas› olabilir.…”

Section: G Gi Ir Ri Ifl Flunclassified

“…Baz› çal›flmalarda, beklenildi¤i üzere, alkalen fosfataz ve iPTH ile KMY de¤erleri aras›nda negatif korelasyon oldu¤u bildirilmifltir (9,11). Di¤er çal›flmalarda ise bizim çal›flmam›zda oldu¤u gibi iPTH ile KMY aras›nda herhangi bir iliflki saptanmam›flt›r (8,(23)(24)(25)(26)(27). Bunun nedeni bu çal›flmalarda hasta say›s›n›n az olmas› ya da serum iPTH ölçüm yöntemlerinin farkl› olmas› olabilir.…”

Section: G Gi Ir Ri Ifl Flunclassified

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Evaluation of Bone Mineral Density in Hemodialysis Patients

Özdemir¹,

Bilgic²

2010

tftr

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Ö Öz ze et tA Am ma aç ç: : ‹leri evre böbrek hastal›¤› olan hastalarda, özellikle hemodiyaliz uygulananlarda, düflük kemik kütlesi frajilite k›r›klar› gibi ciddi sa¤l›k sorunlar›na yol açabilir ve hastalar›n yaflam kalitesi üzerinde olumsuz etkileri olabilir. Bu çal›flman›n amac› bir grup hemodiyaliz hastas›nda kemik mineral yo¤unlu¤unu (KMY) belirlemek ve baz› klinik parametreler ve biyokimyasal kemik döngüsü belirleyicileri aras›ndaki iliflkileri de¤erlendir-mektir. G Ge er re eç ç v ve e Y Yö ön nt te em m: : Çal›flmaya yafl ortalamas› 49,1±16,4 y›l olan 30 hemodiyaliz hastas› dahil edildi. KMY ölçümleri lomber vertebralardan (L2-L4) ve femur boynundan dual enerji X-ray absorbsiyometri (DXA) kullan›larak gerçeklefltirildi. Hemodiyaliz seans› öncesinde kalsiyum, fosfor, alkalen fosfataz, intakt paratiroid hormon (iPTH) gibi biyokimyasal kemik döngüsü belirleyicileri ve plazma bikarbonat, kan pH's›, serum albümin ve hematokrit seviyeleri gibi biyokimyasal kemik döngüsü belirleyicileri ölçüldü. B Bu ul lg gu ul la ar r: : Hastalar›n ortalama lomber vertebra ve femur boynu T-skorlar› s›ras›yla -1,6±0,8 ve -2,6±1,1 idi. Dünya Sa¤l›k Örgütü'nün KMY T-skorlar›-na dayanan kriterlerine göre lomber vertebralarda, hastalar›n %7'si osteoporotik, %60'› osteopenik, %33'ü normaldi. Di¤er taraftan, femur boynunda sonuçlar %50 osteoporotik, %40 osteopenik ve %10 normal fleklindeydi. Femur boynu osteoporotik olanlarla olmayanlar aras›nda yafl, diyaliz süresi ve iPTH seviyeleri bak›m›ndan belirgin fark gözlenmedi. Her iki bölgenin KMY ile hastalar›n yafllar›, diyaliz süreleri ve serum kalsiyum, fosfor, alkalen fosfataz, iPTH de¤erleri aras›nda herhangi bir korelasyon bulunmad›. Her iki cins aras›nda KMY ve biyokimyasal kemik döngüsü belirleyicileri bak›m›ndan istatistiksel olarak anlaml› bir fark yoktu. S So on nu uç ç: : Biz bu çal›flmada hemodiyalize giren hastalar›n %53'ünde özellik-le femur boynunda olmak üzere osteoporozun oldu¤unu tespit ettik. Bu nedenle, kronik hemodiyaliz hastalar›nda kemik sa¤l›¤›n›n iyilefltirilmesi amac›yla femur boynu KMY ölçümlerinin düzenli aral›klarla yap›lmas›n› öneriyoruz. Türk Fiz T›p Rehab Derg 2010;56:62-6. A An na ah ht ta ar r K Ke el li im me el le er r: : Hemodiyaliz, osteoporoz, kemik mineral yo¤unlu¤u, DXA S Su um mm ma ar ry y O Ob bj je ec ct ti iv ve e: : Low bone mass in end-stage renal disease patients, especially those undergoing hemodialysis, can lead to serious health problems such as fragility fractures and may have negative impact on their quality of life. The aim of this study was to determine bone mineral density (BMD) in a group of hemodialysis patients and to evaluate its relationship with several clinical parameters and markers of biochemical bone turnover. M Ma at te er ri ia al ls s a an nd d M Me et th ho od ds s: : Thirty hemodialysis patients, with a mean age of 49.7±16.0 years, were included in the study. The BMD was measured at the lumbar spine (L2-L4) and at the proximal femur by dual-energy X-ray absorptiometry (DXA). Markers of biochemical bone turnover such ...

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Muscular strength and bone mineral density in haemodialysis patients

Abstract: This study reveals the close relationship that exists between muscular strength of the proximal muscles and the BMD of proximal femur in patients undergoing haemodialysis.

Cited by 36 publications

References 2 publications

Exercise in the End-Stage Renal Disease Population

Exercise in the End-Stage Renal Disease Population

The Osteoporotic Effect of Arteriovenous Fistula on the Ipsilateral Upper Extremity in Hemodialysis Patients

Evaluation of Bone Mineral Density in Hemodialysis Patients

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