Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients

Abstract Loss of bone mineral density (BMD) is a substantial risk of mortality in addition to fracture in hemodialysis patients. However, the factors affecting BMD are not fully determined. We conducted a single-center, cross-sectional study on 321 maintenance hemodialysis patients who underwent eva...

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Autores principales:	Hiroko Hashimoto, Satomi Shikuma, Shintaro Mandai, Susumu Adachi, Shinichi Uchida
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/edd9b6e01ac945fbaab5d188f8836652
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spelling	oai:doaj.org-article:edd9b6e01ac945fbaab5d188f88366522021-12-02T13:48:53ZCalcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients10.1038/s41598-021-81287-42045-2322https://doaj.org/article/edd9b6e01ac945fbaab5d188f88366522021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81287-4https://doaj.org/toc/2045-2322Abstract Loss of bone mineral density (BMD) is a substantial risk of mortality in addition to fracture in hemodialysis patients. However, the factors affecting BMD are not fully determined. We conducted a single-center, cross-sectional study on 321 maintenance hemodialysis patients who underwent evaluation of femoral neck BMD using dual-energy X-ray absorptiometry from August 1, 2018, to July 31, 2019. We examined factors associated with osteoporosis defined by T-score of ≤ − 2.5, using logistic regression models. Median age of patients was 66 years, and 131 patients (41%) were diagnosed with osteoporosis. Older age, female, lower body mass index, diabetes mellitus, and higher Kt/V ratios were associated with higher osteoporosis risk. The only medication associated with lower osteoporosis risk was calcium-based phosphate binders (CBPBs) [odds ratio (OR), 0.41; 95% confidence interval (CI), 0.21–0.81]. In particular, CBPB reduced the osteoporosis risk within subgroups with dialysis vintage of ≥ 10 years, albumin level of < 3.5 mg/dL, active vitamin D analog use, and no proton pump inhibitor (PPI) use. In conclusion, CBPB use was associated with lower osteoporosis risk in hemodialysis patients. This effect might be partially attributable to calcium supplementation, given its higher impact in users of active vitamin D analogs or non-users of PPI, which modulate calcium absorption.Hiroko HashimotoSatomi ShikumaShintaro MandaiSusumu AdachiShinichi UchidaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hiroko Hashimoto Satomi Shikuma Shintaro Mandai Susumu Adachi Shinichi Uchida Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
description	Abstract Loss of bone mineral density (BMD) is a substantial risk of mortality in addition to fracture in hemodialysis patients. However, the factors affecting BMD are not fully determined. We conducted a single-center, cross-sectional study on 321 maintenance hemodialysis patients who underwent evaluation of femoral neck BMD using dual-energy X-ray absorptiometry from August 1, 2018, to July 31, 2019. We examined factors associated with osteoporosis defined by T-score of ≤ − 2.5, using logistic regression models. Median age of patients was 66 years, and 131 patients (41%) were diagnosed with osteoporosis. Older age, female, lower body mass index, diabetes mellitus, and higher Kt/V ratios were associated with higher osteoporosis risk. The only medication associated with lower osteoporosis risk was calcium-based phosphate binders (CBPBs) [odds ratio (OR), 0.41; 95% confidence interval (CI), 0.21–0.81]. In particular, CBPB reduced the osteoporosis risk within subgroups with dialysis vintage of ≥ 10 years, albumin level of < 3.5 mg/dL, active vitamin D analog use, and no proton pump inhibitor (PPI) use. In conclusion, CBPB use was associated with lower osteoporosis risk in hemodialysis patients. This effect might be partially attributable to calcium supplementation, given its higher impact in users of active vitamin D analogs or non-users of PPI, which modulate calcium absorption.
format	article
author	Hiroko Hashimoto Satomi Shikuma Shintaro Mandai Susumu Adachi Shinichi Uchida
author_facet	Hiroko Hashimoto Satomi Shikuma Shintaro Mandai Susumu Adachi Shinichi Uchida
author_sort	Hiroko Hashimoto
title	Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
title_short	Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
title_full	Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
title_fullStr	Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
title_full_unstemmed	Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
title_sort	calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/edd9b6e01ac945fbaab5d188f8836652
work_keys_str_mv	AT hirokohashimoto calciumbasedphosphatebinderuseisassociatedwithlowerriskofosteoporosisinhemodialysispatients AT satomishikuma calciumbasedphosphatebinderuseisassociatedwithlowerriskofosteoporosisinhemodialysispatients AT shintaromandai calciumbasedphosphatebinderuseisassociatedwithlowerriskofosteoporosisinhemodialysispatients AT susumuadachi calciumbasedphosphatebinderuseisassociatedwithlowerriskofosteoporosisinhemodialysispatients AT shinichiuchida calciumbasedphosphatebinderuseisassociatedwithlowerriskofosteoporosisinhemodialysispatients
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Calcium-based phosphate binder use is associated with lower risk of osteoporosis in hemodialysis patients

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