PREVALENCE OF OSTEOPOROSIS AND OSTEOPENIA IN CHRONIC KIDNEY DISEASE IN EASTERN INDIA

Introduction:

Chronic kidney disease (CKD) is mostly associated with mineral bone disorder (MBD), osteopenia, osteoporosis and fragility fractures. However, we have limited data of the prevalence of osteopenia and osteoporosis in CKD patients.

This is a single centred, cross sectional prospective study to find the prevalence of osteoporosis and osteopenia in CKD stage (3-5 ND) (ND-Non Dialysis) patients in a tertiary care referral centre of Eastern India, IPGMER & SSKM Hospital, Kolkata, West Bengal, India.

Methods:

This is a hospital based prospective cross-sectional study which was carried out in chronic kidney disease patients in stage (3-5ND) who attended Nephrology Department, IPGMER & SSKM hospital for a period of one year, from July 2023 to July 2024. 206 no. patients, randomly assigned in this study.

Exclusion criteria as per study “Patients on renal replacement therapy, post renal transplant, patients on anti-resorptive drugs (bisphosphonates), contraceptives, pregnant women”.

Osteoporosis and osteopenia were confirmed by DEXA BMD (Dual energy X-ray absorptiometry-Bone Mineral Density) scan (L1-L4 spine, left and right femur).

T-score ≤ -2.5 at either or both sites considered for DEXA BMD scan as osteoporosis and between -1 and -2.5 is considered as osteopenia.

Results:

A total number of 206 CKD stage (3-5ND) patients were screened during the period, July 23 to July 24. The prevalence of osteoporosis was found 32.5% in overall population with 23.8% in male and 47.3% in female population; while that of osteopenia found 67.9% in overall population with 71.9% in male and 61.8% in female population. The mean T-score observed in overall population was -1.75± 1.38 at L1-L4 spine, -1.37± 0.97 left femur and -1.41± 0.98, right femur. In male, mean T-score was -1.42 ±1.38 at the L1-L4 spine, -1.20± 0.92 left femur and -1.21± 0.92 right femur while in female, it was -2.31± 0.124 at L1-L4 (L-lumber) spine, -1.67 ± 1.00 at left femur and -1.76± 0.985 at right femur. The correlation coefficient between L1-L4 spine T-score and eGFR (estimated Glomeralar Filtration Rate by CKD EPI Creatinine formula) was 0.03, with T-score left femur was 0.32 and with T-score right femur was 0.30 in the overall population. In male, the correlation coefficients were -0.01, 0.40 and 0.38 while in female, 0.13, 0.18 and 0.17 between eGFR with T-score L1-L4 spine, left femur and right femur respectively.

Conclusions:

This data of Osteopenia and osteoporosis is alarming as osteopenia itself is considered a serious risk factor for future osteoporosis and fractures.

Further, moderate positive correlation found between femur T-score in overall population and male and weak positive correlation in female with eGFR, which was not found in case of L1-L4 spine T-score which suggests CKD patients are more prone to have lower T-score at femur with lowering eGFR but it requires further studies to confirm its association. Early intervention for diagnosis and timely initiation of treatment of osteoporosis is recommended for CKD population to prevent complications like fracture and frails.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.