TitleFemoral bone mineral density reflects histologically determined cortical bone volume in hemodialysis patients.
Publication TypeJournal Article
Year of Publication2010
AuthorsAdragao, T, Herberth, J, Monier-Faugere, M-C, Branscum, AJ, Ferreira, A, Frazao, JM, Malluche, HH
JournalOsteoporos Int
Date Published04/2010
KeywordsAbsorptiometry, Photon, Adult, Age Factors, Aged, Biopsy, Bone Density, Calcinosis, Cross-Sectional Studies, Female, Femur, Humans, Ilium, Kidney Failure, Chronic, Lumbar Vertebrae, Male, Middle Aged, Porosity, Renal Dialysis, Vascular Diseases, Young Adult

UNLABELLED: We evaluated the associations between dual energy X-ray absorptiometry (DXA) and histologically determined cancellous and cortical bone volume by controlling for vascular calcifications and demographic variables in hemodialysis (HD) patients. Femoral bone mineral density (f-BMD) was associated with cortical porosity.

INTRODUCTION: Assessment of bone mass in chronic kidney disease patients is of clinical importance because of the association between low bone volume, fractures, and vascular calcifications. DXA is used for noninvasive assessment of bone mass whereby vertebral results reflect mainly cancellous bone and femoral results reflect mainly cortical bone. Bone histology allows direct measurements of cancellous and cortical bone volume. The present study evaluates the association between DXA and histologically determined cancellous and cortical bone volumes in HD patients.

METHODS: In 38 HD patients, DXA was performed for assessment of bone mass, anterior iliac crest bone biopsies for bone volume, and multislice computed tomography for vascular calcifications.

RESULTS: While lumbar bone mineral density (l-BMD) by DXA was not associated with histologically measured cancellous bone volume, coronary Agatson score showed a borderline statistically significant association (P = 0.055). When controlled for age and dialysis duration, f-BMD by DXA was associated with cortical porosity determined by histology (P = 0.005).

CONCLUSIONS: The usefulness of l-BMD for predicting bone volume is limited most probably because of interference by soft tissue calcifications. In contrast, f-BMD shows significant association with cortical porosity.

Alternate JournalOsteoporos Int
PubMed ID19554246
PubMed Central IDPMC4501027
Grant ListR01 DK051530 / DK / NIDDK NIH HHS / United States
R01 DK51530 / DK / NIDDK NIH HHS / United States