Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the relationship of clinic features, bone mineral density (BMD) and the risk  of osteoporosis in patients with endstage renal disease (ESRD) prospectively.
Ｍｅｔｈｏｄｏｌｏｇｙ：This study included six hundred and twenty patients with ESRD who admitted in the department of Nephrology, the first affiliated hospital of Nanjing Medical University from December 1st, 2013 to December 1st, 2015. All the patients were checked BMD with dualenergy Xray absorptiometry, and divided into 3 groups by T value at femoral neck as normal bone mass (T≥-10,n=118) , low bone mass (-25＜T＜-10,n=330) and osteoporosis (T≤-25,n=172). The clinic features and analyzed them with logistic regression such as hemoglobin, serum creatinine, urea nitrogen, albumin, total-calcium, phosphorus, alkaline phosphatase (ALP), iPTH and 25(OH)D were also collected.
Ｒｅｓｕｌｔｓ：Their average age was 502±145 years. 465 of 620 patients were undergoing regular dialysis, and the average dialysis age was 53±48 years. There was no significant difference in osteoporosis group among primary nephropathy, diabetic nephropathy, lupus nephritis and any other type of nephropathy-induced ESRD. There was also no significant difference between dialysis or not in all 3 groups, so did dialysis age. The level of phosphorus in osteoporosis group was lower than other two groups (P＜005).But the level of calcium or hemoglobin had no significant difference in three groups. ALP and iPTH had negative correlation with bone mass respectively (P＜001). Univariate logistic regression analysis showed that female, menopausal status, age, weight, BMI, level of phosphorus, iPTH and ALP were risk factors of osteoporosis. Multiple logistic regression analysis showed that increasing age, lower weight, higher level of iPTH and ALP were independent risk factors of osteoporosis. The area under curve of receiver operating characteristic curve was 0762.
Ｃｏｎｃｌｕｓｉｏｎ：There was no correlation between morbidity of osteoporosis and primary diseases in patients with ESRD. Age, weight, level of iPTH and ALP could predict the risk of osteoporosis. The increasing age, lower weight, higher level of iPTH and ALP may lead to higher morbidity of osteoporosis. Taken together, these clinical features may assist the prediction of the risk of osteoporosis and help timely interventions in renal osteodystrophy.