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

Research output: Contribution to journalArticle

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 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.

Details

Authors
Organisations
External organisations
  • Skåne University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Orthopedics
  • Urology and Nephrology

Keywords

  • BMD, eGFR, Elderly, Kidney disease, Mineral homeostasis, Women
Original languageEnglish
Pages (from-to)3463-3473
JournalOsteoporosis International
Volume28
Issue number12
Publication statusPublished - 2017
Publication categoryResearch
Peer-reviewedYes