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Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women : a 10-year longitudinal study

Malmgren, L.; McGuigan, F. LU ; Christensson, A. LU and Akesson, K. E. LU (2017) In Osteoporosis International 28(12). p.3463-3473
Abstract

Summary: Kidney function decreases with age; however, the long-term influence on bone density (BMD) in older women already at risk of osteoporosis is unknown. We followed kidney function and bone loss for 10 years. Declining kidney function was adversely associated with bone loss and mineral homeostasis in old women, though it attenuated with advanced aging. Introduction: Existing studies do not fully address the relationship between kidney function and bone metabolism with advanced aging in Caucasian women. This study describes the association between kidney function, BMD, bone loss and bone metabolism in older women and provides a review of the available literature for context. Methods: We studied participants from the OPRA cohort... (More)

Summary: Kidney function decreases with age; however, the long-term influence on bone density (BMD) in older women already at risk of osteoporosis is unknown. We followed kidney function and bone loss for 10 years. Declining kidney function was adversely associated with bone loss and mineral homeostasis in old women, though it attenuated with advanced aging. Introduction: Existing studies do not fully address the relationship between kidney function and bone metabolism with advanced aging in Caucasian women. This study describes the association between kidney function, BMD, bone loss and bone metabolism in older women and provides a review of the available literature for context. Methods: We studied participants from the OPRA cohort with follow-up after 5 and 10 years. Using plasma cystatin C (cysC), estimated glomerular function rate (eGFR) was evaluated at age 75 (n = 981), 80 (n = 685) and 85 (n = 365). Women were stratified into “normal” function (CKD stages 1–2), “intermediate” (stage 3a) and “poor” (stages 3b–5), and outcome measures—BMD, bone loss and markers of mineral homeostasis—were compared. Results: Femoral neck (FN) BMD positively associated with kidney function at 75 years old ((Formula presented.) = 0.001, p = 0.028) and 80 years old ((Formula presented.) = 0.001, p = 0.001), although with small effect size. Prevalence of osteoporosis (FN T-score ≤ − 2.5) did not differ with kidney function. Measured at age 75, women with poor kidney function had higher annual percentage bone loss over 5 years compared to those with normal function (2.3%, 95% CI 1.8–2.8 versus 1.3%, 95% CI 1.1–1.5, p = 0.007), although not when measured from age 80 or 85. Additionally, markers of mineral homeostasis (PTH, phosphate, vitamin D, calcium), CRP and osteocalcin differed by kidney function. Conclusions: In old women, kidney function is associated with BMD, bone loss and altered mineral homeostasis; probably, a relationship attenuated in the very elderly.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
BMD, eGFR, Elderly, Kidney disease, Mineral homeostasis, Women
in
Osteoporosis International
volume
28
issue
12
pages
3463 - 3473
publisher
Springer
external identifiers
  • scopus:85031941698
  • wos:000415317300019
ISSN
0937-941X
DOI
10.1007/s00198-017-4221-y
language
English
LU publication?
yes
id
76da8057-671e-45d7-b1a2-81735721bd1e
date added to LUP
2017-11-08 09:52:19
date last changed
2018-02-08 03:00:02
@article{76da8057-671e-45d7-b1a2-81735721bd1e,
  abstract     = {<p>Summary: Kidney function decreases with age; however, the long-term influence on bone density (BMD) in older women already at risk of osteoporosis is unknown. We followed kidney function and bone loss for 10 years. Declining kidney function was adversely associated with bone loss and mineral homeostasis in old women, though it attenuated with advanced aging. Introduction: Existing studies do not fully address the relationship between kidney function and bone metabolism with advanced aging in Caucasian women. This study describes the association between kidney function, BMD, bone loss and bone metabolism in older women and provides a review of the available literature for context. Methods: We studied participants from the OPRA cohort with follow-up after 5 and 10 years. Using plasma cystatin C (cysC), estimated glomerular function rate (eGFR) was evaluated at age 75 (n = 981), 80 (n = 685) and 85 (n = 365). Women were stratified into “normal” function (CKD stages 1–2), “intermediate” (stage 3a) and “poor” (stages 3b–5), and outcome measures—BMD, bone loss and markers of mineral homeostasis—were compared. Results: Femoral neck (FN) BMD positively associated with kidney function at 75 years old ((Formula presented.) = 0.001, p = 0.028) and 80 years old ((Formula presented.) = 0.001, p = 0.001), although with small effect size. Prevalence of osteoporosis (FN T-score ≤ − 2.5) did not differ with kidney function. Measured at age 75, women with poor kidney function had higher annual percentage bone loss over 5 years compared to those with normal function (2.3%, 95% CI 1.8–2.8 versus 1.3%, 95% CI 1.1–1.5, p = 0.007), although not when measured from age 80 or 85. Additionally, markers of mineral homeostasis (PTH, phosphate, vitamin D, calcium), CRP and osteocalcin differed by kidney function. Conclusions: In old women, kidney function is associated with BMD, bone loss and altered mineral homeostasis; probably, a relationship attenuated in the very elderly.</p>},
  author       = {Malmgren, L. and McGuigan, F. and Christensson, A. and Akesson, K. E.},
  issn         = {0937-941X},
  keyword      = {BMD,eGFR,Elderly,Kidney disease,Mineral homeostasis,Women},
  language     = {eng},
  month        = {10},
  number       = {12},
  pages        = {3463--3473},
  publisher    = {Springer},
  series       = {Osteoporosis International},
  title        = {Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women : a 10-year longitudinal study},
  url          = {http://dx.doi.org/10.1007/s00198-017-4221-y},
  volume       = {28},
  year         = {2017},
}