- Secondary hyperparathyroidism (SHPT) is associated with low bone mineral density (BMD) among patients with chronic kidney disease (CKD), the hip being the most affected site.
Why this matters
- Hip involvement may reflect greater impairment of cortical vs trabecular bone.
- Findings may shed light on higher rate of hip vs spine fracture in CKD.
- Review of dual-energy X-ray absorptiometry and biochemical data from 1172 patients with CKD (81.3% female, 79.9% white, 8.1% with diabetes).
- Mean estimated glomerular filtration rate (eGFR, in mL/minute/1.73 m2), 73±35.
- Funding: Conselho Nacional de Desenvolvimento Científico e Tecnológico.
- 32.7% had osteopenia, and 20.0% had ≥1 osteoporotic site.
- Prevalence of osteopenia and osteoporosis increased with CKD stage.
- Stage ≥3 CKD was associated with greater likelihood of hip involvement.
- No significant association between CKD stage and BMD at the spine (P=.871).
- Hip osteopenia/osteoporosis was predicted by SHPT (levels ≥65 pg/mL; relative risk [RR]=1.954; P=.0001) and older age (per year, RR=1.043; P=.0001).
- Compared with eGFR ≥90, odds of osteopenia/osteoporosis was:
- 51% higher with eGFR of 30-60 (OR, 1.51; 95% CI, 1.01-2.24).
- 91% higher with eGFR of 15-30 (OR, 1.91; 95% CI, 1.13-3.20).
- Observational, single-center study.