CHARACTERISTICS OF MINERAL AND BONE DISORDERS, BONE MINERAL DENSITY, AND RELATED FACTORS IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Main Article Content
Abstract
Objective: This study evaluated mineral and bone disorders, bone mineral density, and related factors in 54 hospitalized patients with chronic kidney disease treated at Hung Vuong General Hospital, Phu Tho province, from April 2024 to September 2025.
Method: This is a descriptive cross-sectional study, identifying variables such as age, gender, BMI; and blood biochemical tests (total calcium, phosphorus, parathyroid hormone), and bone density measurement. The normal thresholds to be achieved are according to KIOGO (2017).
Results: The mean age was 66 ± 16 years, and 64.8% of patients were older than 60 years. Most patients had chronic kidney disease stage 3 (70.3%). Abnormalities in mineral metabolism included elevated parathyroid hormone, hypocalcemia, and hypophosphatemia, with prevalences of 14.8%, 20.4%, and 13.0%, respectively. Osteopenia and osteoporosis were observed in 38.9% and 33.3% of patients. Mean bone mineral density values at the lumbar spine, femoral neck, and total hip were 0.98 ± 0.24 g/cm2, 0.82 ± 0.21 g/cm2, and 0.85 ± 0.21 g/cm², respectively. Osteoporosis was significantly associated with advanced age, low BMI, and reduced serum phosphorus levels (p < 0.05). Estimated glomerular filtration rate showed a positive correlation with total hip bone mineral density. Multivariable logistic regression analysis identified age (OR = 1.067), BMI (OR = 0.717), and serum calcium concentration (OR = 0.010) as independent factors associated with osteoporosis. Mineral and bone disorders and low bone mineral density are common in hospitalized chronic kidney disease patients, particularly in older individuals with low BMI and altered mineral metabolism.
Conclusion: Bone density screening and monitoring for bone mineral disorders are essential from stages 3-5 of chronic kidney disease, in order to detect early risk of osteoporosis and intervene promptly to minimize bone complications and improve the quality of life for patients.
Article Details
Keywords
Chronic kidney disease, bone mineral density, osteoporosis.
References
[2] Eckardt K.U, Kasiske B.L. Kidney Disease: Improving Global Outcomes. Nat Rev Nephrol, 2009, 5 (11): 650-657.
[3] Kang D.H, Park C.H et al. Kidney function and bone mineral density in chronic kidney disease patients. Clinical Kidney Journal, 2024, 17 (9): sfae248. doi: 10.1093/ckj/sfae248.
[4] Najar M.S, Mir M.M, Muzamil M. Prevalence of osteoporosis in patients with chronic kidney disease (stages 3-5) in comparison with age- and sex-matched controls: a study from Kashmir Valley tertiary care Center. Saudi Journal of Kidney Diseases and Transplantation, 2017, 28 (3): 538-544.
[5] KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl (2011), 2017, 7 (1): 1-59. doi: 10.1016/j.kisu.2017.04.001.
[6] World Health Organization. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. WHO Technical Report Series 843, Geneva, 1994.
[7] Bạch Thị Nhớ, Trần Thị Tô Châu, Đặng Thị Việt Hà. Khảo sát mật độ xương và các yếu tố liên quan ở bệnh nhân suy thận mạn tại Bệnh viện 19-8. Tạp chí Y học Việt Nam, 2023, 527 (1B): 359-363.
[8] Lê Văn Hùng, Phạm Văn Bùi. Khảo sát rối loạn canxi, phospho, PTH và mật độ xương ở bệnh thận mạn giai đoạn tiền lọc máu tại Bệnh viện Chợ Rẫy. Tạp chí Y học thành phố Hồ Chí Minh, 2021, 25 (3): 108-113.
[9] Đỗ Gia Tuyển, Nguyễn Văn Thanh. Mật độ xương ở bệnh nhân suy thận mạn giai đoạn 3 và 4, Tạp chí Nghiên cứu Y học, 2011, 76 (5): 21-28.
[10] Kuang C, Shang J et al. Risk factors and clinical prediction models for osteoporosis in pre-dialysis chronic kidney disease patients. Renal Failure, 2024, 46 (2): 2361802.
[11] Ye Y, Yi X et al. Association between renal function and bone mineral density in patients with type 2 diabetes mellitus. Heliyon, 2023, 9 (4): e15967. doi: 10.1016/j.heliyon.2023.e15967
[12] Nguyễn Minh Quân, Võ Tam. Loãng xương ở người cao tuổi mắc bệnh thận mạn: tỷ lệ và các yếu tố ảnh hưởng. Tạp chí Sức khỏe và Lão hóa, 2025, 1 (3): 47-53.