Vertebral fractures are highly prevalent in patients with end-stage renal disease (ESRD), and abnormal parathyroid hormone (PTH) levels might contribute to this risk, according to new study findings presented at the 56th European Renal Association-European Dialysis and Transplant Association’s Congress in Budapest, Hungary.
Vertebral fractures occurred in 50 (34%) of 146 dialysis patients based on lateral chest radiographs, Thijs Jansz, MD, of University Medical Center Utrecht in the Netherlands, and his collaborators reported. In addition, 20 (29%) of 70 patients with follow-up radiographs displayed new vertebral fractures after a median 1.8 years. The mean age of the study population was 52 years, 67% were male, and median dialysis duration was 26 months.
Vertebral bone mineral density (BMD), measured with computed tomography, did not account for increased fracture risk. But PTH correlated with vertebral fractures in an apparent U-shaped curve. Patients with low PTH (less than 11 pmol/L) had a non-significant 2.3-fold greater risk than the reference group (PTH 11 to 29 pmol/L), but the highest PTH group (30 pmol/L or more), had a significant 2.8-fold greater risk, after adjusting for potential confounders.
Even undiagnosed vertebral fractures negatively impact physical functioning, quality of life, and mortality, Dr Jansz and colleagues noted. Patients with PTH levels around 29 pmol/L appeared to have the lowest risk of these fractures.
Jansz T, Goto N, Van Ballegooijen A, Willems H, Verhaar M, Van Jaarsveld B. The prevalence and incidence of vertebral fractures in end-stage renal disease and the role of parathyroid hormone. Presented at the European Renal Association-European Dialysis and Transplant Association 56th Congress in Budapest, Hungary. Abstract FC023.