medigraphic.com

2009, Number 5

<< Back Next >>

Cir Cir 2009; 77 (5)

Estado del funcionamiento renal de pacientes con osteoporosis primaria (tipo 2)

Nava-Bringas TI, Chávez-Arias DD, Diez-García MP, Miranda-Duarte A

Language: Spanish
References: 22
Page: 375-380
PDF size: 94.48 Kb.


ABSTRACT

Background: Several studies correlate renal function with lower bone mineral density (BMD); however, the relationship between early stages of renal dysfunction and BMD has not been clearly defined. Our objective was to determine renal function in patients with primary osteoporosis (type 2) and its relationship with BMD.
Methods: Patients with primary osteoporosis diagnosed using DEXA were evaluated in this cross-sectional analysis. Renal function was estimated according to the modification of diet in renal disease (MDRD) equation and classified according to the National Kidney Foundation for chronic kidney disease (CKD). The relationship between renal function and BMD was analyzed.
Results: Included in the study were 120 women with a mean age 67.9 ± 6.56 years. There was a positive relationship between spine BMD and moderate affection of renal function (F = 4.860, p = 0.009). No relationship was found between hip BMD or fracture with renal function (p = 0.223).
Conclusions: Although women with poor renal function have significantly lower spine BMD, no relationship between early stages of CKD and low BMD has been demonstrated.


REFERENCES

  1. Moe SM. Vascular calcification and renal osteodystrophy relationship in chronic kidney disease. Eur J Clin Invest 2006;36:51-62.

  2. Ersoy F. Osteoporosis in the elderly with chronic kidney disease. Int Urol Nephrol 2007;39:321-331.

  3. Drinka P. The importance of parathyroid hormone and vitamin D status in the treatment of osteoporosis and renal insufficiency. J Am Med Dir Assoc 2004;5:382-386.

  4. Buchanan JR, Myers C, Greer R. Effect of declining renal function on bone density in aging women. Calcif Tissue Int 1988;43:1-6.

  5. Fried L, Shlipak M, Stehman-Breen C, Mittalhenkle A, Seliger S, Sarnak M, et al. Kidney functions predicts the rate of bone loss in older individuals: The Cardiovascular Health Study. J Gerontol 2006;71:743-748.

  6. Negri AL, Lombas C, Zanchetta JR. Relación entre función renal y densidad mineral ósea en mujeres posmenopáusicas que realizan evaluación de masa ósea. Nefrologia 2006;26:206-211.

  7. Ensrud K, Lui LY, Taylor B, Ishani A, Shlipak M, Stone K, et al. Renal function and risk of hip and vertebral fractures in older women. Arch Intern Med 2007;167:133-139.

  8. Tannenbaum C, Clark J, Schwartzman K. Yield of laboratory testing to identify secondary contributors to osteoporosis in otherwise healthy women. J Clin Endocrinol Metab 2002;87:4431-4437.

  9. Reza A, Vergara A, Mendoza V, Martínez C, Zúñiga S, Leo H, et al. Osteoporosis. Posición de la Sociedad Mexicana de Nutrición y Endocrinología. Rev Endocrinol Nutr 2004;12:123-163.

  10. Stevens L, Coresh J, Greene T, Levey A. Assessing kidney function. Measured and estimated glomerular filtration rate. N Engl J Med 2006;354:2473-2483.

  11. Verhave J, Fesler P, Ribstein J, Cailar G, Mimran A. Estimation of renal function in subjects with normal serum creatinine levels: influence of age and body mass index. Am J Kidney Dis 2005;46:233-241.

  12. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002;39(2 Suppl 1):S1-S266.

  13. Riggs BL. Overview of osteoporosis. West J Med 1991;154:63-77.

  14. Hamanoa T, Osetoa S, Fujiia N, Itoa N, Katayamab M, Horioa M, et al. Impact of lowering dialysate calcium concentration on serum bone turnover markers in hemodialysis patients. Bone 2005;36:909-916.

  15. Khan S. Vitamin D deficiency and secondary hyperparathyroidism among patients with chronic kidney disease. Am J Med Sci 2007;333:201-207.

  16. Klawansky S, Komaroff E, Cavanaugh P, Mitchell D, Gordon M, Connelly J, et al. Relationship between age, renal function and bone mineral density in the US population. Osteoporos Int 2003;14:570-576.

  17. Hsu C, Cummings S, McCulloch C, Chertow G. Bone mineral density is not diminished by mild to moderate chronic renal insufficiency. Kidney Int 2002;61:1814-1820.

  18. Dukas L, Schacht E, Stähelin H. In elderly men and women treated for osteoporosis a low creatinine clearance of <65 ml/min is a risk factor for falls and fractures. Osteoporos Int 2005;16:1683-1690.

  19. Jassal S, Von Muhlen D, Barrett-Connor E. Measures of renal function, BMD, bone loss, and osteoporotic fracture in older adults: The Rancho Bernardo Study. J Bone Miner Res 2007;22:203-210.

  20. Heaney RP. Pathophysiology of osteoporosis. Am J Med Sci 1996;312: 215-216.

  21. Hughes DE, Dai A, Tiffee JC. Estrogen promotes apoptosis of murine osteoclasts mediated by TGF-beta. Nat Med 1996;2:1132-1136.

  22. Werth VP. Glucocorticoid-induced osteoporosis. Evaluation, prevention, and treatment. J Clin Rheumatol 1997;3:S69-S73.




2020     |     www.medigraphic.com