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Association of Reduction in Bone Mineral Density with Mortality in Male Hemodialysis Patients

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Abstract

In the present study we examined the relationship of bone mineral density (BMD) reduction with increased mortality in hemodialysis patients. A single-center prospective observational study was conducted on 269 male hemodialysis patients. The BMD in the distal third of the radius (DR1/3) and in the ultradistal radius (UR), which are enriched with cortical and cancellous bone, respectively, was measured twice using dual-energy X-ray absorptiometry (DXA) with a 1-year interval. Subjects were divided into two groups based on the presence or absence of BMD reduction. Survival was followed for 61.0 months, after which time 104 patients (39%) had died. A significant BMD reduction at the UR and DR1/3 occurred in 182 (68%) and 195 (72%) patients, respectively. Patients with BMD reduction in the UR, in contrast to the DR1/3, had a significantly lower survival rate than those without BMD reduction (P = 0.01). In Cox regression analysis, the rate of BMD change at the UR, in addition to patient age, diabetes mellitus, and serum albumin, emerged as an independent predictor for increased mortality (HR = 0.970, 95% CI 0.945–0.996). Our results suggest that BMD reduction at the UR might be a clinically relevant marker that predicts an increased risk of mortality in male hemodialysis patients.

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Authors and Affiliations

  1. Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    Kaori Kohno, Masaaki Inaba, Senji Okuno, Yoshifumi Maeno, Kiyoshi Maekawa, Tomoyuki Yamakawa, Eiji Ishimura & Yoshiki Nishizawa

  2. Shirasagi Hospital, Osaka, Japan

    Kaori Kohno, Masaaki Inaba, Senji Okuno, Yoshifumi Maeno, Kiyoshi Maekawa, Tomoyuki Yamakawa, Eiji Ishimura & Yoshiki Nishizawa

Authors
  1. Kaori Kohno
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  2. Masaaki Inaba
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  3. Senji Okuno
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  4. Yoshifumi Maeno
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  5. Kiyoshi Maekawa
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  6. Tomoyuki Yamakawa
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  7. Eiji Ishimura
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  8. Yoshiki Nishizawa
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Correspondence to Masaaki Inaba.

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Kohno, K., Inaba, M., Okuno, S. et al. Association of Reduction in Bone Mineral Density with Mortality in Male Hemodialysis Patients. Calcif Tissue Int 84, 180–185 (2009). https://doi.org/10.1007/s00223-008-9206-6

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  • DOI: https://doi.org/10.1007/s00223-008-9206-6

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