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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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.

作者简介

Sergey Mazurenko

Saint Petersburg State University; Sokolov Clinical Hospital №122

编辑信件的主要联系方式.
Email: dr_mazurenko@mail.ru
ORCID iD: 0000-0002-1915-2237

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

俄罗斯联邦, Saint Petersburg

Yakov Nakatis

Saint Petersburg State University; Sokolov Clinical Hospital №122

Email: dr_mazurenko@mail.ru

д.м.н., проф.; глав. врач

 
俄罗斯联邦, Saint Petersburg

Aleksander Enkin

Leningrad Regional Clinical Hospital

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

зав. отд-нием диализа

俄罗斯联邦, Saint Petersburg

Konstantin Staroselsky

City Hospital №26

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

зав. отд-нием диализа

俄罗斯联邦, Saint Petersburg

Aleksander Vasiliev

Pavlov First Saint Petersburg State Medical University

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

зав. отд-нием хронического гемодиализа

俄罗斯联邦, Saint Petersburg

Oksana Mazurenko

Sokolov Clinical Hospital №122

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

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

俄罗斯联邦, Saint Petersburg

Petr Soin

City Hospital №26

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

врач отд-ния диализа

俄罗斯联邦, Saint Petersburg

Larisa Ermolaeva

City Hospital №26

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

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

俄罗斯联邦, Saint Petersburg

Igor Ivanov

Saint Petersburg State University

Email: dr_mazurenko@mail.ru
俄罗斯联邦, Saint Petersburg

参考

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  10. Mazurenko SO, Mazurenko OG, Enkin AA, et al. Use of dual energy x-ray absorptiometry for assessment of fracture risk in dialysis patients. Biomed Eng. 2017;51:20. doi: 10.1007/s10527-017-9676-9
  11. DeLoach SS, Townsend RR. Vascular Stiffness: Its Measurement and Significance for Epidemiologic and Outcome Studies. Clin J Am Soc Nephrol. 2008;3(1):184-92. doi: 10.2215/CJN.03340807
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