Impact of vascular calcifications on the risk of fractures in patients with chronic kidney disease

IF 3.5 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2025-03-14 DOI:10.1016/j.bone.2025.117455

Alejandro Godoy , Maria Paula Dionisi , Anyelo Cardozo , Pehuén Fernández , Daniela Porta , Aldo Tabares , Carlos Chiurchiu , Javier de Arteaga , Jorge de la Fuente , Walter Douthat , María Angélica Rivoira

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引用次数: 0

Abstract

Background

The decline in kidney function adversely affects mineral and bone disease, leading to decreased bone mass, increased fractures, and vascular calcifications (VC), particularly in advanced CKD stage 5. This study aimed to identify VC markers to eventually develop personalized therapeutic and preventive strategies in Argentina, where data is limited.

Methods

A prospective, observational study included 101 patients on dialysis or pre-dialysis, eligible for kidney transplant at the Private University Hospital of Córdoba from June 2019 to December 2020. Clinical, laboratory, and imaging assessments were conducted, measuring bone mineral density (BMD), pulse wave velocity (PWV), and VC presence. Patients were grouped based on VC status for comparative analysis.

Results

VC was found in 28 % of patients, correlating significantly with age, BMI, time on dialysis, deceased donor type, and PWV (p < 0.01). PTH showed a direct correlation with total alkaline phosphatase (ALP), bone-specific alkaline phosphatase, P1NP, osteocalcin, and telopeptides. ALP was significantly higher in the VC group (median = 149.5, range [62–964] vs. median = 106, range [28–449]; p < 0.01). Patients without VC had higher serum albumin levels (OR = 0.16; p = 0.002; CI = 0.05–0.52). Fracture prevalence was 32.1 % in the VC group compared to 13.1 % without VC (p < 0.02), with logistic regression showing VC increased fracture risk threefold (OR = 3.09; p = 0.01; CI = 1.22–7.83).

Conclusion

This study highlights the high prevalence of VC and increased fracture risk in CKD stage 5 patients. ALP is a potential serum marker for bone metabolism, while lower serum albumin levels suggest chronic inflammation may contribute to VC development.

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.