The value of bone mineral density assessment by dual-energy x-ray absorptiometry for prediction of cardiovascular mortality in patients treated with hemodialysis

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Abstract


Aim. Determine whether bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry can be used as predictor of increased risk of death in hemodialysis patients.

Materials and methods. A prospective study was performed of 516 patients with chronic kidney disease treated with hemodialysis (men – 265, women – 251, mean age 44.8±11.4 years) who were observed for 5.7±3.2 years.

Before inclusion in the study, in all patients was analyzed bone mineral density using dual-energy X-ray absorptiometry in three standard departments: lumbar vertebrae, proximal femur and distal forearm. The probability analysis of the outcome was carried out using the Kaplan–Meier method and Cox.

Results. During follow-up period 111 (21.5%) patients died, 50.5% from cardiovascular events. Survival analysis by Kaplan–Meier method allowed to prove the increased risk of death from cardiovascular pathology in hemodailysis patients with low bone mineral density of all evaluated areas. Step-by-step multivariate Cox regression analysis showed that the T score of the femur, showing the difference of BMD of the patient with normal value of BMD for young adult, had the greatest prognostic significance.

Conclusion. Reduced bone mineral density in patients receiving hemodialysis is associated with an increased risk of death from cardiovascular disease. Dual energy x-ray absorptiometry can be used for assessment of this risk.


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About the authors

Sergey O. Mazurenko

Saint Petersburg State University; Sokolov Clinical Hospital №122

Author for correspondence.
Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0002-1915-2237

Russian Federation, Saint Petersburg

д.м.н., проф., зав. каф. пропедевтики внутренних болезней; рук. Центра остеопороза и метаболических заболеваний скелета

Yakov A. Nakatis

Saint Petersburg State University; Sokolov Clinical Hospital №122

Email: dr_mazurenko@mail.ru

Russian Federation, Saint Petersburg

д.м.н., проф.; глав. врач

 

Aleksander A. Enkin

Leningrad Regional Clinical Hospital

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0003-2305-9673

Russian Federation, Saint Petersburg

зав. отд-нием диализа

Konstantin G. Staroselsky

City Hospital №26

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0002-3956-1628

Russian Federation, Saint Petersburg

зав. отд-нием диализа

Aleksander N. Vasiliev

Pavlov First Saint Petersburg State Medical University

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0002-0529-3880

Russian Federation, Saint Petersburg

зав. отд-нием хронического гемодиализа

Oksana G. Mazurenko

Sokolov Clinical Hospital №122

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0003-1922-5309

Russian Federation, Saint Petersburg

к.м.н., врач-рентгенолог Центра остеопороза и метаболических заболеваний скелета

Petr V. Soin

City Hospital №26

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0003-4162-6686

Russian Federation, Saint Petersburg

врач отд-ния диализа

Larisa G. Ermolaeva

City Hospital №26

Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0002-5040-6768

Russian Federation, Saint Petersburg

к.м.н., доц. каф. пропедевтики внутренних болезней

Igor G. Ivanov

Saint Petersburg State University

Email: dr_mazurenko@mail.ru

Russian Federation, Saint Petersburg

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