Value of quantitative ultrasound and bioelectrical impedance analysis in detecting low bone mineral density in hemodialysis.

Abstract:

INTRODUCTION:Patients on maintenance hemodialysis (MHD) are highly predisposed to low bone mineral density (BMD). This study aims to assess the value of quantitative ultrasound (QUS), bioelectrical impedance analysis (BIA), and their combination in detecting high-risk patients for low BMD in MHD. METHODS:Patients' BMD of the total hip, femoral neck, and lumbar spine were measured using dual-energy X-ray absorptiometry (DXA). Bone mineral content (BMC) was assessed using BIA. Calcaneal BMD was measured using QUS. Patients with a T-score of ≤-2.5 were recorded as 'low BMD.' RESULTS:Overall, 93 subjects (62.37% female; mean age, 60.8 ± 16.2 years) were included in this cross-sectional study; approximately 36.56% met the 'low BMD' criteria. QUS-T score predicted low BMD with an area under the curve (AUC) value of 0.738, sensitivity of 70.59%, and specificity of 76.27%. The AUC for low BMD diagnosis using the BMC index (BMCI) measured through BIA was 0.679 (sensitivity, 91.18%; specificity, 38.98%). On the other hand, the combination of QUS-T score and BMCI yielded a higher AUC value of 0.762 with an improved specificity of 88.14%. Compared with the QUS and BIA alone, the net reclassification improvement (NRI) of the combination model increased by 47.16% (p = 0.022) and 78.36% (p < 0.0001), respectively. Integrated discrimination improvement (IDI) increased by 5.25% (p = 0.043) and 9.99% (p = 0.003), respectively. QUS-T score and BMCI were related to BMD independently assessed by DXA. CONCLUSION:The combination of QUS and BIA is effective in screening for low BMD among MHD patients.

journal_name

Ren Fail

journal_title

Renal failure

authors

Xiang T,Zhou L,Fu P,Yan XP,Zeng XQ

doi

10.1080/0886022X.2021.1959347

keywords:

["Low bone mineral density","bioelectrical impedance analysis","hemodialysis","osteoporosis","quantitative ultrasound"]

subject

Has Abstract

pub_date

2021-12-01 00:00:00

pages

1198-1204

issue

1

eissn

0886-022X

issn

1525-6049

journal_volume

43

pub_type

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