Increased Osteoporosis Rate Observed in Peritoneal Dialysis Patients: Study

A recent study published in the Public Library of Science journal uncovered the prevalence of osteoporosis among patients who were undergoing peritoneal dialysis (PD). The study helps to understand the bone health of these patients by employing bone mineral density (BMD) measurements through dual-energy X-ray absorptiometry (DEXA) scans which can reveal critical insights into the skeletal complications underwent by this vulnerable group.

The cross-sectional study enrolled a total of 76 patients from the dialysis center at the An-Najah National University Hospital in Nablus, Palestine by focusing on the lumbar spine and hip regions to assess BMD. The research utilized T-scores from DEXA scans to quantify bone density and conducted a multivariate analysis to explore potential associations with various clinical and biochemical parameters.

The results revealed that over half (52.6%) of the PD patients were found to have osteoporosis. The study highlighted a significant association between lower body mass index (BMI) and reduced BMD with patients expressing lower BMI showing a higher prevalence of osteoporosis (p<0.001). Also, the patients with higher levels of alkaline phosphatase were more likely to be osteoporotic (p = 0.045).

A particularly concerning finding was the widespread of vitamin D deficiency among the study population which affected around 86.6% of the participants. Despite this high prevalence, no significant correlation was found between 25 vitamin D levels and BMD, nor was there a significant link between parathyroid hormone (PTH) levels and BMD. This suggests that other factors might be at play in the deterioration of bone health among PD patients.

The study illuminates the critical need for proactive measures to address the bone health in PD patients. With a notable proportion of these patients at risk of fractures due to decreased BMD, there is a increased need for healthcare providers to implement strategies to reduce this risk. The positive correlation between BMI and BMD in the femoral neck area that points to the potential benefits of nutritional and lifestyle interventions in maintaining or improving bone density.

The findings of this study provide a strong case for elevated awareness and targeted interventions to manage and improve bone health in PD patients. The comprehensive analysis of the clinical and biochemical factors associated with BMD in PD patients offers valuable insights for both clinicians and patients. Also, steps can be taken to reduce the risk of fractures and other complications by recognizing the critical role of bone health and the factors influencing it which can ultimately improve patient outcomes in this high-risk group.

Reference:

Tamimi, R., Bdair, A., Shratih, A., Abdalla, M., Sarsour, A., Hamdan, Z., & Nazzal, Z. (2024). Bone mineral density and related clinical and laboratory factors in peritoneal dialysis patients: Implications for bone health management. In P. Khashayar (Ed.), PLOS ONE (Vol. 19, Issue 5, p. e0301814). Public Library of Science (PLoS). https://doi.org/10.1371/journal.pone.0301814