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Risk factors and renal outcomes of low bone mineral density in patients with non-dialysis chronic kidney disease

Authors
 Y Y Hyun  ;  K-B Lee  ;  S H Han  ;  K H Choi  ;  H C Park  ;  Y K Oh  ;  S K Park  ;  K-H Oh  ;  C Ahn 
Citation
 OSTEOPOROSIS INTERNATIONAL, Vol.31(12) : 2373-2382, 2020-12 
Journal Title
OSTEOPOROSIS INTERNATIONAL
ISSN
 0937-941X 
Issue Date
2020-12
MeSH
Absorptiometry, Photon ; Adult ; Aged ; Bone Density ; Bone Diseases, Metabolic* / epidemiology ; Bone Diseases, Metabolic* / etiology ; Female ; Humans ; Male ; Middle Aged ; Renal Insufficiency, Chronic* / complications ; Risk Factors
Keywords
Bone mineral density ; Chronic kidney disease ; Renal outcome ; Risk factor
Abstract
Bone disorder is a common complication of chronic kidney disease (CKD). The clinical usefulness of bone mineral density (BMD) in CKD is not well known. Our study shows that low BMD is associated with physical activity and dietary Na/K intake ratio and can predict poor renal outcome in non-dialysis CKD. Purpose Despite evidence of a link between bone mineral disorders and chronic kidney disease (CKD), the clinical implications of bone mineral density (BMD) in CKD are not well established. We investigated risk factors and renal outcomes of low BMD in CKD. Methods We analyzed data from the KNOW-CKD. BMD measured by dual-energy x-ray absorptiometry was classified byTscore: normal (Tscore >= - 1.0), osteopenia (- 1.0 > Tscore > - 2.5), and osteoporosis (Tscore <= - 2.5) of the lumbar spine, hip, or femoral neck. Logistic regression analysis to assess risk factors of low BMD (Tscore < - 1.0) and Cox proportional hazards models to estimate risk of incident end-stage renal disease (ESRD). Results Low BMD was prevalent (osteopenia 33%; osteoporosis 8%) in 2128 adults with CKD (age 54 +/- 12 years; male 61%). Over a median follow-up of 4.3 years, there were 521 cases of incident ESRD. Lower BMD was associated with female sex, older age, low eGFR, low BMI, and lifestyle factors of physical activity (odds ratio (OR) = 0.62, 95% confidence interval (0.49-0.77)) and spot urine Na/K ratio (1.07 (1.00-1.15)). In adjusted Cox models, low BMD was associated with increased incident ESRD (hazard ratio (HR) = 1.14 (0.92-1.41) for osteopenia; 1.43 (1.01-2.04) for osteoporosis,Pfor trend < 0.05) compared with the reference of normal BMD. The association between low BMD and ESRD was similar according toTscore discordance classification. Conclusions Low BMD was associated with modifiable lifestyle factors including low physical activity and high dietary Na/K intake ratio. The presence of low BMD is associated with poor renal outcomes in non-dialysis CKD.
Full Text
https://link.springer.com/article/10.1007/s00198-020-05531-9
DOI
10.1007/s00198-020-05531-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189911
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