Erythropoiesis Does not Infl uences on Bone Mineral Density in Patients with Late Stage of Chronic Kidney Disease

초록

Background: Hypoxia aggravates bone mass loss meanwhile in vitro studies demonstrated erythropoietin (EPO) increases bone mass by increasing mesenchyme parenchymal cells. The purpose of present study is to investigate the impact of erythropoiesis status on bone mineral density (BMD) in patients with late stage of chronic kidney disease (CKD). Methods: Cross-sectional analysis was carried out with 61 CKD patients on CKD stage 3-4 (32 males vs 29 females; mean age of 51 ± 14 (32-72); diabetes 40 vs non-diabetes 21 patients). BMD was measured by DEXA +using Hologic QDR. Laboratory fi ndings including hemoglobin, iron, ferritin, calcium, phosphorus, parathyroid hormone level and duration and dose of erythropoietin (EPO) were compared in relation with BMD. Results: T score of spine and femur was less than -2.5 (osteoporotic) in 27 (44%), -1.0 to -2.5 (osteopenic) in 26 (42%) and more than -1.0 (normal) in 8 patients (8%). Hemoglobin correlated negatively with T score. Average dose and duration of EPO show no signifi cant correlation with BMD. Age and intact PTH correlated negatively and body mass index (BMI) and corrected calcium level correlated positively with T score. PTH was related with decreased BMD in spine. Linear regression analysis showed age, corrected calcium, and weight are independent predictors of BMD. Conclusions: Erythropoiesis status and treatment with EPO does not influence on bone density status in late CKD patients. It was shown independently related with age, BMI and calcium level. Spine bone density may infl uenced by PTH level. Further study is required to prove the relationship between treatment with EPO and bone mineral density in CKD patients.