Estimating the Proportion of Bone Mineral Density Loss in Patients with Normal Kidney Function among South Indian Population

Abstract Background: Bone Mineral density (BMD) is considered as one of the golden tool to measure the bone quality in which two measurements namely T- Score and Z –score are used to report the BMD test results. Whenever there is deterioration of BMD it is associated with low skeletal mass. Creatinine is a chemical waste molecule that is generated from this muscle metabolism. Creatinine is a good marker for muscle mass. However, limited studies have been done which tell us the association between BMD loss and serum creatinine (SCr) levels.Methodology: 200 participants who were referred for CECT abdomen and pelvis were scanned using 128 slice Philips Brilliance CT. Using BMD software, four different vertebral bodies from L1-L4 were taken and ROI was placed at the central portion of the trabecular bone, two reference ROI’s, one in retro spinal muscle and one in fat tissue were also placed. To measure CT attenuation value, a ROI graphic tool was drawn at the trabecular bone. Average HU of BMD, T score and Z score values were taken from L1-L4.Statistical Analysis: The data was analysed using SSPS version 16.0. For assessment of normal BMD values, the results of measurements were averaged for age, creatinine level, T score and Z score and descriptive statistics was calculated. Spearman’s correlation coefficient was used to estimate the correlation between serum creatinine with T score and Z score.Results: T Score and SCr correlated negatively at -0.25. The correlation between Z Score and SCr was also negatively correlated at -0.187.Conclusion: It was evident from the study findings, that there is a non-association between SCr and T Score levels which showed that BMD of a person was not associated with normal kidney function. Thus, SCr levels cannot be used as a biomarker for osteoporosis or osteopenia.

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Secondary Hyperparathyroidism in HIV-Infected Patients in Central Europe

Hormone and Metabolic Research ◽

10.1055/s-0043-125073 ◽

2018 ◽

Vol 50 (04) ◽

pp. 317-324 ◽

Cited By ~ 6

Author(s):

Sebastian Noe ◽

Celia Oldenbuettel ◽

Silke Heldwein ◽

Carmen Wiese ◽

Ariane von Krosigk ◽

...

Keyword(s):

Risk Factors ◽

Secondary Hyperparathyroidism ◽

Kidney Function ◽

Normal Kidney ◽

Mineral Density ◽

Hiv Patients ◽

Bone Mineral Density Loss ◽

Normal Kidney Function ◽

Low Calcium ◽

Increased Risk

AbstractSecondary hyperparathyroidism (sHPT) might be a contributor to increased risk of osteoporosis in adult HIV patients but there is little data available on this issue in this particular population. The aim of the study was to investigate the prevalence of sHPT in an HIV-infected population with normal kidney function and to evaluate its risk factors in HIV patients. This cross-sectional study was carried out in a single HIV center in Germany using routine data from patients with normal kidney function attending the clinic between January 1st and December 31st, 2016. In total, 1263 patients were included [998 (79.0%) male, median age 48 (IQR 38–54) years]. In 214 patients (16.9%) elevated PTH levels with low or normal calcium levels were found. Multivariate logistic regression modeling showed significant associations with elevated PTH for African ethnicity [OR: 2.12 (95% CI: 1.42–3.16); p<0.001], low 25-hydroxyvitamin D levels [OR: 1.82 (95% CI: 1.32–2.51); p<0.001], low calcium levels [OR 1.69 (95% CI: 1.22–2.33); p=0.001], and use of tenofovir disoproxil fumarate [OR 2.33 (95% CI: 1.62–3.36); p<0.001]. Additional to common risk factors like vitamin D insufficiency and hypocalcemia, we found a significant association between the use of TDF and sHPT. Prospective data are needed to ascertain whether PTH-mediated bone loss is the underlying mechanism of TDF bone-toxicity. Additional screening of PTH even in HIV-infected patients with normal or low calcium levels may help to identify patients at increased risk of bone mineral density loss.

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Cinacalcet-Associated Resolution of Primary Hyperparathyroidism in a Patient With Normal Kidney Function

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709620936836 ◽

2020 ◽

Vol 8 ◽

pp. 232470962093683 ◽

Cited By ~ 1

Author(s):

Son Nguyen ◽

Elvira O. Gosmanova ◽

Aidar R. Gosmanov

Keyword(s):

Bone Mineral Density ◽

Chronic Kidney Disease ◽

Primary Hyperparathyroidism ◽

Kidney Function ◽

Calcium Supplementation ◽

Normal Kidney ◽

Mineral Density ◽

Calcium Supplements ◽

Normal Kidney Function

Cinacalcet use is associated with risk of hypocalcemia; however, this risk has been mostly demonstrated in patients with chronic kidney disease. In this article, we describe a case of a 59-year-old male with primary hyperparathyroidism (PHPT), hypercalciuria, osteopenia, and normal kidney function who was started on cinacalcet for the management of recurrent hypercalcemia following prior unsuccessful parathyroidectomy. Within 6 months following cinacalcet commencement, he developed symptomatic and biochemical hypocalcemia requiring discontinuation of the medication and initiation of calcium supplementation. Over more than 3 years of follow-up, his calcium supplementation was gradually tapered off and then discontinued. He is presently eucalcemic and euparathyroid off calcium supplements while also demonstrating normalization of hypercalciuria and bone mineral density. These data indicate that our patient has experienced resolution of PHPT after brief exposure to cinacalcet. We recommend that low starting cinacalcet doses should be considered for treatment of hypercalcemia in patients with PHPT who underwent unsuccessful parathyroidectomy along with close clinical and biochemical follow-up.

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