RESUMO
BACKGROUND: End-stage renal disease (ESRD) is a condition in which bone turnover and metabolism is impaired; thus, osteoporosis and low bone density are subsequently inevitable. We aimed to determine bone mineral density (BMD) and biochemical markers, and associated factors in hemodialysis (HD) patients. METHODS: Patients aged 30-70 years undergoing HD between 2015 to 2019 were enrolled in this cross-sectional study. BMD measured by dual energy x-ray absorptiometry (DEXA) and biochemical laboratory tests were assessed in 200 patients undergoing HD. Statistical analysis was based on t test, Pearson, regression and Mann-Whitney tests using SPSS 16. RESULTS: Two hundred patients were investigated. Sixty percent of the patients were female. Mean ± SD of participants' age was 58.6 (±11.63) years and mean ± SD for duration of HD was 45.69 (± 43.76) months. Osteoporosis was found in 48% (n=96) and low bone density in 36% (n=76) of our patients. General osteoporosis was more frequent in those undergoing HD for more than 3 years, although not significantly (P=0.093, odds ratio [OR]=0.37). However, regional osteoporosis in hip and femoral neck, but not spine vertebrae, were significantly higher after three years of HD (P=0.036, OR=0.27; P=0.042, OR=0.27; and P=0.344, OR=0.56, respectively). Increased body mass index (BMI) correlated negatively with osteoporosis (P=0.050). CONCLUSION: With increasing age and duration of HD, BMD decreases. Higher BMI was associated with higher bone mass density. Bone density assessment seems to be necessary in patients undergoing HD.
Assuntos
Densidade Óssea , Diálise Renal , Absorciometria de Fóton , Idoso , Estudos Transversais , Feminino , Colo do Fêmur/diagnóstico por imagem , Humanos , Irã (Geográfico)/epidemiologia , Vértebras Lombares , Pessoa de Meia-IdadeRESUMO
PURPOSE: The commonly used 24-hour collection technique has been the mainstay of diagnosis for supersaturation but has some certain limitations. Hence, superiority of multiple short urine collections as a new alternative in precipitation risk assessment was assessed compared to the standard 24-hour urine collection among healthy subjects. MATERIALS AND METHODS: Individual urine samples of 26 healthy subjects were acquired every 2 to 3 hours throughout the 24 hours. Urine samples were obtained and the time and volume of each sample were recorded. Urinary constituents involved in precipitation including, sodium-potassium, chloride, calcium, phosphate, citrate, magnesium, urea, creatinine and pH were measured. A simulated 24-hour collection was recalculated by the totalling of all shorter urine collections volume and urinary constituents excretions throughout the day. RESULTS: Urine pH, urine creatinine and precipitation rate had a significantly lower values in 24-hours urine collection compared to one individual value of multiple urine collections by -0.769 (P < .0001), -7.305 (P < .0001), and - 12.838 (P < .0001), respectively. However, calcium (2.697, P < .0001), citrate (3.54, P < .0001), total phosphate (19.961, P < .0001) and total creatinine (9.579, P < .0001) had statistically significantly higher values in the 24-hours urine collection compared to individual value of multiple urine collections. CONCLUSION: Based on the results, individual analysis of multiple shorter urine collections throughout the day improves the ability of identifying supersaturation points, precipitation risk zones and may potentially improve risk assessment compared to the 24-hour urine collection method.