Bone mineral density and related clinical and laboratory factors in peritoneal dialysis patients: Implications for bone health management.

BACKGROUND: End-stage renal disease (ESRD) patients often experience accelerated bone turnover, leading to osteoporosis and osteopenia. This study aimed to determine the prevalence of osteoporosis in Peritoneal Dialysis (PD) patients using bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DEXA) scan and to explore any possible associations with clinical and biochemical factors. METHODS: In this cross-sectional study, we enrolled 76 peritoneal dialysis patients from the dialysis center at An-Najah National University Hospital in Nablus, Palestine. We used the DEXA scan to measure BMD at the lumbar spine and hip, with values expressed as T-scores. We conducted a multivariate analysis to explore the relationship between BMD and clinical and biochemical parameters. RESULTS: Over half (52.6%) of the PD patients had osteoporosis, with a higher prevalence observed among patients with lower BMI (p<0.001). Higher alkaline phosphatase levels were found among osteoporotic patients compared to non-osteoporotic patients (p = 0.045). Vitamin D deficiency was also prevalent in this population, affecting 86.6% of patients. No significant correlation was found between 25 vitamin D levels and BMD. No significant correlation was found between Parathyroid hormone (PTH) levels and BMD. CONCLUSION: A notable proportion of PD patients experience reduced BMD. Our study found no correlation between vitamin D levels and BMD, but it highlighted the significant vitamin D deficiency in this population. Furthermore, our analysis indicated a positive correlation between BMI and BMD, especially in the femoral neck area. This underscores the significance of addressing bone health in PD patients to mitigate the risk of fractures and improve their overall well-being.

Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries.

Despite the high prevalence of osteoporosis and vitamin D deficiency, the knowledge about osteoporosis and vitamin D-related practices were moderate in some countries in the Middle East and North Africa (MENA) region. Improving knowledge through awareness campaign and screening programs is essential to enhance vitamin D-related practices. PURPOSE: Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region. METHODS: A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices. RESULTS: Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001). CONCLUSION: Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.