Low bone volume--a risk factor for coronary calcifications in hemodialysis patients

Clin J Am Soc Nephrol. 2009 Feb;4(2):450-5. doi: 10.2215/CJN.01870408. Epub 2009 Jan 21.


Background and objectives: There is increasing evidence that altered bone metabolism is associated with cardiovascular calcifications in patients with stage 5 chronic kidney disease on hemodialysis (HD). This study was conducted to evaluate the association between bone volume, turnover, and coronary calcifications in HD patients.

Design, setting, participants, & measurements: In a cross-sectional study, bone biopsies and multislice computed tomography were performed in 38 HD patients. Bone volume/total volume, activation frequency, and bone formation rate/bone surface were determined by histomorphometry and coronary calcifications were quantified by Agatston scores.

Results: Prevalence of low bone turnover was 50% and of low bone volume was 16%. Among the studied traditional cardiovascular risk factors, only age was found to be associated with coronary calcifications. Lower bone volume was a significant risk factor for coronary calcifications during early years of HD, whereas this effect was not observed in patients with dialysis duration >6 yr. Histomorphometric parameters of bone turnover were not associated with coronary calcifications.

Conclusions: Low bone volume is associated with increased coronary calcifications in patients on HD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Biopsy
  • Bone Remodeling*
  • Calcinosis / etiology*
  • Calcinosis / pathology
  • Calcinosis / physiopathology
  • Chronic Disease
  • Coronary Artery Disease / etiology*
  • Coronary Artery Disease / pathology
  • Coronary Artery Disease / physiopathology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ilium / diagnostic imaging
  • Ilium / pathology*
  • Ilium / physiopathology
  • Kidney Diseases / complications
  • Kidney Diseases / pathology
  • Kidney Diseases / physiopathology
  • Kidney Diseases / therapy*
  • Male
  • Middle Aged
  • Odds Ratio
  • Organ Size
  • Renal Dialysis / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Young Adult