Nutritional markers, not markers of bone turnover, are related predictors of bone mineral density in chronic peritoneal dialysis patients

Background and aims This study evaluated the factors associated with bone mineral density (BMD) in chronic peritoneal dialysis (CPD) patients Methods In this cross-sectional study in 91 stable CPD patients, BMD was measured using dual-energy X-ray absorptiometry Markers of bone turnover (iPTH, osteocalcin, bone alkaline phosphatase, serum C-telopeptide), 25-hydroxy (OH) vitamin D-3 and nutritional markers (prealbumin, nPNA, BMI) were measured by standard techniques Results Of the 91 patients, 48 were female and 22 (24%) had Type 2 diabetes Mean age of the patients was 52 7, and patients had been on PD for about 44 months For the lumbar spine (LS) and femoral neck (FN), the mean T-scores were -1 19 +/- 1 53 and 1 24 +/- 1 01, respectively, and the mean Z-scores were -0 78 +/- 1 33 and -0 40 +/- 0 92, respectively Using the WHO-based criteria, osteopenia (-2 5 < T-score < -1 0) at the LS and FN was observed in 37 (41%) and 48 (53%) patients, respectively, and osteoporosis (T-score <= -2 5) at the LS and FN was observed in 15 (17%) and 6 (7%) patients, respectively LS T-score was positively correlated with BMI (r = 0 40, p < 0 001) and albumin (r = 0 29, p = 0 005), and FN T-score was positively correlated with albumin (r = 0 40, p < 0 001), prealbumin (r = 038, p < 0 001), age (r = -0 32, p = 0 002) and BMI (r = 0 29, p < 0 006) Markers of bone turnover were not associated with BMD In multiple linear regression models, independent predictors of FN T-score were age, BMI, albumin and prealbumin (r(2) = 0 259, F = 6 23, p < 0 001), whereas BMI was the only independent predictor of LS T-score (r(2) = 0 24, F = 6 63, p < 0 001) Conclusion Nutritional markers, not markers of bone turnover, are correlated predictors of BMD in CPD patients