Najar M Saleem, Mir Mohamad Muzzafer, Muzamil Mudasir
Department of Nephrology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
Saudi J Kidney Dis Transpl. 2017 May-Jun;28(3):538-544. doi: 10.4103/1319-2442.206439.
Chronic kidney disease (CKD) is associated with a range of metabolic bone diseases. Fracture rates are higher in CKD patients than age-matched controls throughout all the five stages of CKD. Dialysis patients have 4 times as many hip fractures as expected for their age. CKD forms an independent risk factor for osteoporosis, even in the absence of traditional risk factors. This study was carried out at the nephrology unit in a tertiary care center of Kashmir to know the prevalence of osteoporosis in CKD patients having glomerular filtration rate (GFR) <60 mL/min (stages 3-5). Among the 151 cases studied, the average estimated GFR was 16.78 ± 10.714 mL/min. There were 98 males (64.9%) and 53 females (35.1%). Their mean age was 51.01 ± 14.138 years. Osteoporosis based on femoral neck T-Score was seen in 31 patients (31.6%) while 43 patients (28.5%) had osteoporosis at L1, L2 lumbar vertebrae. The prevalence of osteoporosis based on femoral neck T-Score as well as osteopenia was highest in stage-5 CKD. In our study, the body mass index (BMI) had a positive correlation with osteoporosis; low BMI patients were at higher risk for osteoporosis (P = 0.014). In the Kashmir valley, the prevalence of osteoporosis was 31.8% in CKD patients against 22% in controls. Thus, CKD forms an important risk factor for osteoporosis even in the absence of traditional risk factors. We recommend early screening, detection, and management of osteoporosis to reduce the burden of morbidity and mortality in this subset of patients.
慢性肾脏病（CKD）与一系列代谢性骨病相关。在CKD的所有五个阶段，CKD患者的骨折发生率均高于年龄匹配的对照组。透析患者的髋部骨折发生率是其年龄预期的4倍。即使没有传统风险因素，CKD也是骨质疏松症的独立危险因素。本研究在克什米尔一家三级医疗中心的肾病科进行，以了解肾小球滤过率（GFR）<60 mL/分钟（3-5期）的CKD患者中骨质疏松症的患病率。在研究的151例病例中，平均估计GFR为16.78±10.714 mL/分钟。有98名男性（64.9%）和53名女性（35.1%）。他们的平均年龄为51.01±14.138岁。基于股骨颈T值的骨质疏松症在31例患者（31.6%）中可见，而43例患者（28.5%）在L1、L2腰椎有骨质疏松症。基于股骨颈T值的骨质疏松症以及骨质减少的患病率在5期CKD中最高。在我们的研究中，体重指数（BMI）与骨质疏松症呈正相关；低BMI患者患骨质疏松症的风险更高（P = 0.014）。在克什米尔山谷，CKD患者中骨质疏松症的患病率为31.8%，而对照组为22%。因此，即使没有传统风险因素，CKD也是骨质疏松症的重要危险因素。我们建议对骨质疏松症进行早期筛查、检测和管理，以减轻这部分患者的发病和死亡负担。
