Diana Moldovan1,2, Crina Rusu3, Alina Potra3, Ioan Moldovan4, Ioan Mihai Patiu5, Mirela Gherman-Caprioara3, Ina Maria Kacso3. 1. Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. dnmoldovan@yahoo.com. 2. Nephrology and Dialysis Clinic, Emergency County Hospital, "Mihai Manasia", 3-5 Clinicilor Street, Cluj-Napoca, Romania. dnmoldovan@yahoo.com. 3. Department of Nephrology, University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. 4. Military Hospital Cluj-Napoca, Cluj-Napoca, Romania. 5. Nefromed Dialysis Center Cluj-Napoca, Cluj-Napoca, Romania.
Abstract
INTRODUCTION: Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HD patients. METHODS: This cross-sectional study has been realized on a cohort of 63 chronic HD patients. INCLUSION CRITERIA: elderly prevalent HD patients with an age over 55 years old. EXCLUSION CRITERIA: previous bone disease or previous renal transplant; neoplasia; parathyroidectomy, hormone replacement therapy. The data regarding demographical and clinical characteristics, including treatments for mineral and cardiovascular complications, were recorded. Serum OPG and mineral markers levels were measured. BMD was assessed by calcaneus quantitative ultrasound; it measured broadband ultrasound attenuation, speed of sound (SOS) and stiffness index (STI). RESULTS: The high OPG levels were associated with higher bone mineral density (OPG-SOS P = 0.003; R = 0.37; OPG-STI P = 0.03; R = 0.28). Malnutrition, anemia and advanced age correlated with bone demineralization. Males had higher bone density parameters than females. In patients treated with vitamin D (P = 0.005), the BMD was increased comparing to patients without these treatments. CONCLUSIONS: OPG levels had directly correlated with bone mineral density parameters. Our study further confirms the critical role of OPG in the pathogenesis of uremic osteoporosis in ESRD. Whether the increased circulant OPG protect against bone loss in patients undergoing HD remains to be established.
INTRODUCTION:Osteoprotegerin (OPG) is a powerful inhibitor of osteoclast activity, and it plays an important role in bone metabolism. In hemodialysis (HD) patients, the relationship between OPG and bone mineral density (BMD) is important, but remains unclear yet. The study objective was to assess the OPG role related to uremic osteoporosis in HDpatients. METHODS: This cross-sectional study has been realized on a cohort of 63 chronic HDpatients. INCLUSION CRITERIA: elderly prevalent HDpatients with an age over 55 years old. EXCLUSION CRITERIA: previous bone disease or previous renal transplant; neoplasia; parathyroidectomy, hormone replacement therapy. The data regarding demographical and clinical characteristics, including treatments for mineral and cardiovascular complications, were recorded. Serum OPG and mineral markers levels were measured. BMD was assessed by calcaneus quantitative ultrasound; it measured broadband ultrasound attenuation, speed of sound (SOS) and stiffness index (STI). RESULTS: The high OPG levels were associated with higher bone mineral density (OPG-SOS P = 0.003; R = 0.37; OPG-STI P = 0.03; R = 0.28). Malnutrition, anemia and advanced age correlated with bone demineralization. Males had higher bone density parameters than females. In patients treated with vitamin D (P = 0.005), the BMD was increased comparing to patients without these treatments. CONCLUSIONS:OPG levels had directly correlated with bone mineral density parameters. Our study further confirms the critical role of OPG in the pathogenesis of uremic osteoporosis in ESRD. Whether the increased circulant OPG protect against bone loss in patients undergoing HD remains to be established.
Authors: Alireza Moayyeri; Stephen Kaptoge; Nichola Dalzell; Sheila Bingham; Robert N Luben; Nicholas J Wareham; Jonathan Reeve; Kay Tee Khaw Journal: J Bone Miner Res Date: 2009-07 Impact factor: 6.741