Bone Mineral Density in Hypo-and Hyper-Parathyroidism Hemodialysis Patients

Since bone mineral density (BMD) may be influenced by the iPTH level in the hemodialysis patients, we conducted a cross-sectional study to investigate BMD (dual photon x-ray absorptionmetry) in our hemodialysis patients. On the basis of their iPTH levels, we divided 67 patients undergoing dialysis into 2 groups: 32 patients with hypoparathyroidism (iPTH ＜65 pg/mI) and 35 patients with hyperparathyroidism (iPTH ＞500 pg/mL). In hypoparathyroidism patients, they were older (62 vs 54 y/o) although hemodialysis period was shorter (54 vs 85 months). When it was adjusted for age and hemodialysis duration, hypoparathyroidism patients had lower serum albumin (3.85±0.3 vs 4.0±0.3 g/dL), calcium (9.6±0.7 vs 10.2±0.5 mg/dL), phosphorus 4.5±1.2 vs 5.9±1.3 mg/dL), bone-specific alkaline phosphatase (18±7.4 vs 41.3±12.3 u/L) levels, and higher T score in BMD measurement, -1.0±0.9 vs -2.3±1.5 in 1/3 ulan, -1.1±1.1 vs -2.4±1.7 in mid-ulnar area. But T score in the lumbar spine, femoral neck, trochanter and distal ulna did not have significant difference between two groups. We conclude BMD measurement may be a potential tool to follow up bone turnover in hypoparathyroidism and hyperparathyroidism hemodialysis patients.

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