Bone mass in chronic renal insufficiency patients treated with continuous ambulatory peritoneal dialysis.

Chronic renal failure (CRF) causes deterioration of the fluid, electrolyte, and acid-base balances, azotemia, and impairment of the structure and function of many systems. In the skeletal system, CRF changes both the quality and quantity of the bone through its multifactorial influence on bone metabolism, leading to osteopenia, osteoporosis, and increased risk of fracture. The aim of the present study was to work up the quickest and most sensitive schedule for detecting osteoporosis in chronic renal insufficiency patients treated with CAPD. Thirty-seven uremic patients were included in the study. Bone mineral density was measured by dual-energy x-ray absorptiometry in lumbar spine, femoral neck, forearm (33% distal and ultradistal sites), and total body. Analyzing all five sites, we made the assessment that the prevalence of osteoporosis in our group of patients reached 48.6%. If only one site was evaluated, the ultradistal part of forearm yielded the highest frequency of diagnosis of osteoporosis (37.8%). Next came the femoral neck and total body (21.6% each). When the two sites in the forearm were taken into account together, the incidence of osteoporosis reached 40.5%. We conclude that the quickest and most sensitive method of detecting osteoporosis in CAPD patients is to measure bone mass in both forearm sites (33% distal and ultradistal), then in the femoral neck.