End-stage renal failure (ESRF) is the ultimate consequence of chronic renal failure, and in such cases dialysis is generally required. Almost all dialysed patients have abnormal bone histology and lower values of glomerular filtration rate have been associated with lower bone mineral density (BMD) at all sites. The objective of the present study was to investigate the effect of hemodialysis (HD) on body-composition (BC), specially segmental and total BMD in Egyptian ESRF patients. Forty ESRF patients (20 male/20 female; age range: 21.00-74.00 yr) undergoing regular HD 3 times/week (duration range: 0.08-20.00 yr) using bicarbonate dialysis and polysulphon membrane were matched with 40 healthy controls for age, height, and sex. Blood samples were obtained and serum levels of calcium (Ca), inorganic phosphate (P), osteocalcin (OC), and parathyroid hormone (PTH) were monitored for all participants. BC was evaluated by dual X-ray absorptiometry. HD patients manifested lower segmental and total BMD values in comparison with age-matched healthy controls (Z-score: -0.17 ± 1.12) due to significantly higher levels of P (4.04 ± 1.33 vs. 3.39 ± 0.51 mg/dl, p<0.001), PTH (538.17 ± 363.99 vs. 48.86 ± 19.64 ng/L, p<0.0001), and OC (50.39 ± 34.91 vs. 16.32 ± 5.37 μg/L, p<0.0001). Pelvis, lumbar spine, and total BMD (g/cm(2)) for HD patients were significantly correlated with HD duration (yr) (R=0.94, 80, and 92, respectively; p<0.0001). Thus, BC analysis is of utmost importance for efficiently providing tailored individual mineral supplementation to HD patients.
Keywords: bone mineral density; dual-enenrgy X-ray absorptiometry; end-stage renal failure; hemodialysis; osteocalcin; parathyroid hormone.