Renal osteodystrophy is well-recognzed complication of chronic renal failure (CRF0 and is associtated with a marked morbidity. Bone mineral density (BMD0 has been shown to be the best predictor of fracture risk in different circumstances. In this
cross-sectional study, we emasured total and regional (head, arm, trunk, rib, elg, spine and pelvis) BMD by dual energy X-ray absorptiometry (DEXA) in 121 patient with CRF[70 predialysis patients. 28 patients on maintenance hemodialysis (HD) and
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patients on continuous ambulatory peritoneal dialysis (CAPD)]. We also examine the validity of serum intact-parathyroid hormone (intact PTH) and as an indicator of secondary hyperparathyroidism. All these skeletal sites are characterized by
relative
amounts of trabecular and cortical bone. The results indicate that decreased bone mass was detectable in skelectal sites except head before the beginning of dialysis and BMD wasnot related to dialysis duration in patients with HD and CAPD,
respectively.
Nevertheless, the deleterious effects of renal osteodyatrophy were most pronounced at pelvis. A separate analysis of BMD in both sexes revealed that females presented a more important bone loss in 5 sites except ribs and pelvis than males. We did
not
find any significant difference in total body an regional BMD at the 7 measured sites between patients on CAPD and maintenance HD.
This study emphasizes the need to pay attention to the prevention of bone loss in patients on CRF before the start of dialysis therapy, and to the fact that female population might dispay a more pronounced susceptibility to bone loss.
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