1. In patients undergoing peritoneal dialysis, osteoporosis is highly prevalent but does not correlate to 25-vitamin D levels.

Evidence Rating Level: 3 (Average) 

One complication in patients with chronic kidney disease (CKD is increased bone turnover and decreased bone density. Bone mineral density (BMD) indicates bone mass and mineralization. It is determined using a Dual-Energy X-ray Absorptiometry (DEXA) scan at both the posteroanterior lumber spine (L1-L4) and the hip (femoral neck or total proximal femur). Previous meta-analysis highlighted the significant relationship between a CKD and a low BMD which increases their fracture risk. Currently, there is conflicting evidence regarding DEXA scan measurements and biochemical markers of osteopenia and osteoporosis. In this cross-sectional study, researchers aimed to determine the prevalence of in patients undergoing peritoneal dialysis (PD) and to correlate the associated biochemical variables. Patients undergoing PD were evaluated for clinical characteristics, biochemical markers, and BMD. Vitamin D investigations showed 86.8% of participants had a deficiency with a median of 8.7ng/mL. BMD measurements revealed an osteoporosis rate of 41% in the femoral neck and 38% in the lumbar spine. A multivariate analysis attempting to correlate 25-vitamin D levels with BMD showed no significant correlation. However, another multivariate analysis showed BMI had a positive correlation with BMD in both the femoral neck and lumbar spine. More investigations into clinical and biochemical markers of osteoporosis in PD patients are needed to begin osteoporosis treatment promptly. Vitamin D supplementation should be considered in PD patients prophylactically. 

Click to read the study in PLOSONE

Image: PD

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