Risk Factors for Low Trabecular Bone Volume among Patients with Chronic Kidney Disease
Name: Lauren Lowe
School: Vagelos College of Physicians and Surgeons, Class of 2026
Mentors: Rosa Moyses, MD, PhD and Michael Yin, MD, MS
Abstract
Research Question: This study evaluated the prevalence of low trabecular bone volume across renal osteodystrophy groups.
Background: Metabolic bone disease is a common complication of chronic kidney disease (CKD), broadly referred to as CKD- mineral and bone disorder (CKD-MBD). It is characterized by biochemical and skeletal abnormalities as well as vascular calcification, while renal osteodystrophy (ROD) exclusively refers to the skeletal abnormalities. ROD can manifest as a high [Osteitis Fibrosa (OF) and Mixed Bone Disease (MD)] or low turnover bone disease [Adynamic Bone Disease (ABD) and Osteomalacia (OM)]. The epidemiologic profile of ROD has shifted with recent drug and dialysis advancements; however, the relationship between ROD type and low trabecular bone volume (BV) has not been explored.
Methods: This was a retrospective cross-sectional subanalysis of the Brazilian Registry of Bone Biopsy (REBRABO) data. Iliac crest bone biopsies were performed between 08/2015-12/2021. Demographic, laboratorial, and bone histomorphometric parameters were analyzed.
Results: The median age and BMI of the 374 patients were 52 (42-60) years and 24.2 (21.7-27.3) kg/m2, respectively. Low BV was found in 50.3% of patients with OF, 54.4% with MD, 67.7% with ABD, and 47.1% with OM. Patients with low BV (52%) were older and with a lower BMI. Low BV also was more common in patients with ABD. Multivariate analysis disclosed that low BV was associated with age (HR =1.05), BMI (HR=0.90), and ABD (HR=1.88).
Conclusions: CKD patients with lower trabecular bone are older, have a lower BMI, and are more likely to have ABD than any other form of ROD.