Study On Factors Related To Osteoporosis In Patients With Maintenance Hemodialysis

Objective:In this study,a retrospective survey was conducted on the patients who had entered maintenance hemodialysis in our hospital to understand the prevalence of osteoporosis and osteopenia in patients with MHD,and to compare the general data and biochemical indexes of the patients,to analyze the related factors affecting bone metabolism and to explore the risk factors of osteoporosis in patients with maintenance hemodialysis.Methods: We selected maintenance hemodialysis patients with stage 5 of chronic kidney disease in our hospital from 2018.01 to 2019.06,and measured forearm bone mineral density at the distal radius with dual-energy X-ray absorptiometry.Patients were divided into osteoporosis group,bone loss group and normal bone mass group.We collected general information of patients and biochemical indicators.We compare the general information and biochemical indicators,analysis the correlation between each indicator and bone density,and evaluate independent risk factors for osteoporosis.Results: We included 164 maintenance hemodialysis patients in this study.There were89 males and 75 females.Age of patients was 66(55.00 to 75.75)years and dialysis age was 36(12.00 to 69.00)months.1.The primary disease of patients were 65 hypertension patients,54 diabetes patients,21 chronic glomerulonephritis patients,and the other 24 patients.2.The number of hyperphosphatemia,hypocalcemia and hypercalcemia was104,46 and 6.The Compliance rate of phosphorus,calcium and i PTH was 58.54%,68.29%and 78.66%.3.There were 28 osteoporosis patients(17.07%),53 bone loss patients(32.32%),83 normal bone mass patients(50.61%),and 18 fractures patients after dialysis(10.98%).4.The bone mineral density T value of females was-1.13(-1.96 ～-0.36)and the bone mineral density T value of males was-0.85(-1.57～-0.14).There was a statistical difference between them(P <0.05).5.There were significant differences in age,BMI,intact parathyroid hormone,serum phosphorus,serum calcium,serum potassium,urea nitrogen,uric acid,post-dialysis fracture history and FRAX evaluation between the three groups.6.Simple correlation analysis showed that bone mineral density was significantly correlated with sex,age,dialysis age,BMI,smoking history,oral phosphate reducer,intact parathyroid hormone,serum phosphorus and serum calcium.7.By stepwise analysis of multiple linear regression,it was found that bone mineral density was negatively correlated with age,dialysis age,serum phosphorus,intact parathyroid hormone,and triglyceride,and positively correlated with BMI,serum calcium and fasting blood glucose.8.Logistic regression analysis showed that age,dialysis age,BMI,and blood calcium were independent risk factors for osteoporosis in maintenance hemodialysis patients.Conclusion: 1.Abnormal bone mineral density is common in patients who have entered maintenance hemodialysis.2.Bone mineral density was negatively correlated with age,dialysis age,serum phosphorus(P),intact parathyroid hormone(i PTH),and triglyceride(TG),and positively correlated with BMI,serum calcium(Ca)and fasting blood glucose.3.Age,dialysis age,BMI and abnormal calcium and phosphorus metabolism can increase the incidence of osteoporosis.