P0881ANEMIA SIGNIFICANTLY INCREASES RISK OF OSTEOPOROSIS IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE

Abstract Background and Aims Anemia was frequently observed in chronic renal failure patients. The risk of osteoporosis is higher in patients with chronic anemia. Chronic anemia also showed a close relationship with bone mineral density. However, few studies have been done whether anemia affects bone mineral density with chronic kidney disease(CKD) patient. Therefore, the aim of our study is to evaluate the relationship between anemia and bone mineral density(BMD) in a large sample of non-dialysis CKD cohort. Method We performed an observational study in 2,089 patients who measured hemoglobin and BMD with non-dialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD). Anemia was defined as hemoglobin(Hb) levels of < 13.0 g/dL for males and 12.0 g/dL for females, respectively. BMD was estimated by dual energy x-ray absorptiometry system. The observed variable was decline of BMD during follow up. Results The mean age was 53.6 ± 12.2 years and 1,292(61.1%) patients were males. The BMD score was positively correlated with hemoglobin levels (β, 0.007; 95% CI, 0.003-0.012; P 0.002), but inversely with prevalence of anemia (β, -0.03; 95% CI, -0.042--0.008; P 0.004). In the multivariable logistic regression model, the prevalence of osteoporosis was significantly higher in the anemia group than that in the normal hemoglobin levels (odds ratio [OR], 1.67; 95% confidence interval [CI], 1.11-2.51, P=0.014). Among 881 patients except unavailable following BMD, 396 (19.7%) patients developed the decline of BMD during a median follow-up duration of 48 (interquartile range, 46-49) months. In the fully adjusted multivariable Cox models, risk of developing the decline of BMD was significantly higher in the anemia group (HR, 1.38; 95% CI, 1.02-1.87; P= 0.036) as compared to normal hemoglobin group. Conclusion We found that anemia is independently and significantly correlated with an increased risk of osteoporosis with non-dialysis CKD. Our study suggests that prompt correction of anemia in CKD patients could be beneficial to preserving bone mineral density.

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Mild Renal Dysfunction Is a Risk Factor for a Decrease in Bone Mineral Density and Vertebral Fractures in Japanese Postmenopausal Women

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-0099 ◽

2010 ◽

Vol 95 (10) ◽

pp. 4635-4642 ◽

Cited By ~ 41

Author(s):

Hiroshi Kaji ◽

Mika Yamauchi ◽

Toru Yamaguchi ◽

Takashi Shigematsu ◽

Toshitsugu Sugimoto

Keyword(s):

Bone Mineral Density ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Renal Dysfunction ◽

Postmenopausal Women ◽

Bone Mineral ◽

Vertebral Fractures ◽

Disease Stage ◽

Mineral Density ◽

Increased Risk

Context: The effect of mild renal dysfunction on bone mineral density and fracture risk is uncertain. Objective: We evaluated whether mild renal dysfunction would affect bone mineral density (BMD) and the risk of vertebral fractures (VFs) in 659 postmenopausal women. Main Outcome Measures: Creatinine clearance (CCr) and the estimated glomerular filtration rate (eGFR) were calculated using the Cockcroft-Gault and the Modification of Diet in Renal Disease formulas, respectively. BMD was measured by dual-energy x-ray absorptiometry. Renal function was categorized by the criteria of the Kidney Disease Outcomes Quality Initiative Committee. Results: Comparison of fracture prevalence by chronic kidney disease stages revealed that the group of stage 3 or greater by eGFR had a significantly higher rate of VFs (45.3%) than stages 1 (23.8%) and 2 (25.3%) groups. In the stage 2 group, there were significant positive correlations between eGFR and BMD values at the femoral neck and radius as well as between CCr and BMD values at all sites. Moreover, postmenopausal women with VFs had lower eGFR and CCr than those without VFs in stage 2. When multivariable logistic regression analysis was performed with the presence of VFs as a dependent variable and CCr levels adjusted for years after menopause, smoking habit, alcohol intake, and lumbar spine BMD as an independent variable, CCr levels were identified as a factor associated with the presence of VFs in postmenopausal women with chronic kidney disease stage 2. Conclusions: The present study indicates that postmenopausal women with mild renal dysfunction are at increased risk for BMD decrease and VFs.

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P0856LOW BONE MASS IS SIGNIFICANTLY ASSOCIATED WITH AN INCREASED RISK OF ANEMIA IN PATIENTS WITH CKD

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0856 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Seonyeong Lee ◽

Yooju Nam ◽

Hyung Woo Kim ◽

Jae Hyun Chang ◽

Tae-Hyun Yoo

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Bone Mass ◽

Mass Density ◽

Bone Mass Density ◽

Mineral Density ◽

Multivariable Logistic Regression Model ◽

Increased Risk ◽

The Relationship

Abstract Background and Aims Hypoxia has been considered to be a risk factor for osteoporosis. Several studies have reported on the close associations between the anemia and an increased risk of bone loss. However, the relationship between hemoglobin levels and bone mineral density(BMD) has not been established in chronic kidney disease (CKD) patients. Therefore, the aim of this study is to investigate the relationship between BMD and anemia in a non-dialysis CKD cohort. Method Among 2,238 patients with non-dialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD), 2,115 patients who measured hemoglobin(Hb) and BMD were included in the analysis. We defined anemia as hemoglobin(Hb) levels of < 13.0 g/dL and 12.0 g/dL for males and females, respectively. The primary endpoint was the onset of a 15% decline in Hemoglobin during follow-up. Results The mean age was 53.6 ± 12.2 years and 1,292(61.1%) patients were males. The BMD score was positively correlated with hemoglobin levels (β, 0.658; 95% CI, 0.215-1.101; P 0.004). In the multivariable logistic regression model, the prevalence of anemia was significantly higher in the osteoporosis group than that in the normal BMD group (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.03-2.46, P=0.038). Among 1010 patients without data of following hemoglobin levels, 396 (19.7%) patients developed 15% decline in hemoglobin level during a median follow-up duration of 36 (interquartile range, 10-60) months. In the fully adjusted multivariable Cox models, risk of developing the 15% decline of hemoglobin was significantly higher in the osteoporosis group (HR, 1.45; 95% CI, 1.03-2.05; P= 0.035) as compared to normal BMD group. Conclusion This study showed that low bone mass density was independently related with anemia and hemoglobin levels in patients with non-dialysis CKD. Our findings suggest that preserve bone mass be important to maintain the levels of hemoglobin with CKD patients.

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