A study of determinants of low bone mineral density in patients with advanced chronic kidney disease

Advancedstages of chronic kidney disease (CKD) are associated with abnormalities inbone and mineral health of the patient. They may manifest as decreased bonemineral density, abnormalities in bone volume, calcification of vascular and/orsoft tissues. Low bone mineral density (BMD) as measured by dual-energy X-rayabsorptiometry, predicts the risk of fragility fracture. Skeletal fractures areimportant cause of CKD-related morbidity.

Despiteof high prevalence of decreased bone mineral density in CKD, diagnosis and roleof bone mineral density remain understudied in India. Further, the studies areneeded to determine the factors associated with low BMD.

Inthis study, we will measure BMD by DEXA scan and determine the prevalence oflow BMD in advanced CKD in Indian population. With the use of statisticaltests, we will observe relationship between low BMD and Stage of CKD,biochemical markers, age, gender and BMI and various other determinants of low BMD.

Thiscross-sectional observational study will be carried out over period of 18months and will include adult patients with advanced CKD, admitted in wards orseen in outpatient of KEM Hospital, Pune. Post renal transplant patients,pregnant, patients with previous spine surgery and those on osteoporosistherapy will be excluded.

Weexpect to determine prevalence of low BMD in advanced CKD in Indian populationand establish relationship between low BMD with stage of CKD, biochemicalmarkers and demographical parameters which will help in early suspicion anddiagnosis of CKD-MBD and effect of modifications in determinants on clinicaloutcome.