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Published ahead of print on January 21, 2009
Clinical Journal of the American Society of Nephrology
© 2009 American Society of Nephrology
doi: 10.2215/CJN.01870408
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Received April 21, 2008
Accepted on November 7, 2008

ORIGINAL ARTICLES

Low Bone Volume—A Risk Factor for Coronary Calcifications in Hemodialysis Patients

Teresa Adragao *, Johann Herberth {dagger}, Marie-Claude Monier-Faugere {dagger}, Adam J. Branscum {ddagger}, Anibal Ferreira {sect}, Joao M. Frazao ||, Jose Dias Curto ||, and Hartmut H. Malluche {dagger}1

*Nephrology Department, Santa Cruz Hospital, Lisbon, Portugal; {dagger}Division of Nephrology, Bone, and Mineral Metabolism and {ddagger}Department of Biostatistics, Statistics, and Epidemiology, University of Kentucky, Lexington, Kentucky; {sect}Nephrology Department, Curry Cabral Hospital, Lisbon, Portugal; ||Nephrology Department, Hospital de S. João, Medical School and Nephrology Research and Development Unit, University of Porto, Porto, Portugal; and ¶ISCTE, Business School, Lisbon, Portugal


1 To whom correspondence should be addressed. E-mail: hhmall{at}uky.edu.


  Abstract

Background and objectives: There is increasing evidence that altered bone metabolism is associated with cardiovascular calcifications in patients with stage 5 chronic kidney disease on hemodialysis (HD). This study was conducted to evaluate the association between bone volume, turnover, and coronary calcifications in HD patients.

Design, setting, participants, & measurements: In a cross-sectional study, bone biopsies and multislice computed tomography were performed in 38 HD patients. Bone volume/total volume, activation frequency, and bone formation rate/bone surface were determined by histomorphometry and coronary calcifications were quantified by Agatston scores.

Results: Prevalence of low bone turnover was 50% and of low bone volume was 16%. Among the studied traditional cardiovascular risk factors, only age was found to be associated with coronary calcifications. Lower bone volume was a significant risk factor for coronary calcifications during early years of HD, whereas this effect was not observed in patients with dialysis duration >6 yr. Histomorphometric parameters of bone turnover were not associated with coronary calcifications.

Conclusions: Low bone volume is associated with increased coronary calcifications in patients on HD.

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Clin. J. Am. Soc. Nephrol. 2009 4: 254-257. [Full Text] [PDF]



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G. M. London
Bone-Vascular Axis in Chronic Kidney Disease: A Reality?
Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 254 - 257.
[Full Text] [PDF]


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