The Incidence Of Osteoporosis In Maintenance Hemodialysis Patients And Its Influencing Factors

Objectives:To observe the effect of different indexes on Bone mineral density?Bone mineral density,BMD?in Maintenance hemodialysis?Maintenance hemodialysis,MHD?patients,and to guide the determination of risk factors of osteoporosis in uremic dialysis patients,so as to prevent osteoporosis,improve the quality of life of patients and extend the life cycle.Methods:This study included 212 patients who received routine hemodialysis in the blood purification center of our hospital from May 2017 to October 2018 as the dialysis group.100 healthy people from the physical examination center of our hospital were selected as the control group to collect clinical data such as gender,age,primary disease,Body mass index?BMI?and dialysis age.Determination of Hemoglobin?Hb?Hemoglobin,before dialysis,serum Calcium(Calcium,Ca²⁺),P(Phosphorus,P³⁺),serum parathyroid hormone by segment?Intact parathyroid hormone,iPTH?indicators such as experiments.Dual-energy X-ray absorptiometry was used to measure the BMD of the distal radius on both sides in all patients.The incidence of abnormal bone mass in dialysis group and control group was compared.The primary incidence in the dialysis group was statistically analyzed and the relationship between the primary incidence and bone mineral density was analyzed.The dialysis group was divided into two groups according to BMD values:normal bone mass group and abnormal bone mass group.Statistical methods were used to compare the age and gender of patients in the two groups.The correlation between hemoglobin,serum calcium,serum phosphorus,serum iPTH,body mass index?BMI?,dialysis age and bone mineral density of patients in the dialysis group was analyzed to explore the risk factors of osteoporosis.Results:In the control group,the incidence of osteoporosis was 6%and the incidence of bone loss was 10%.The incidence of osteoporosis was 9.4%in dialysis group and69.8%in dialysis group,which was significantly higher than that in healthy subjects?P<0.05?.The primary morbidity of the dialysis group was divided into 76 cases of diabetic nephropathy,32 cases of chronic glomerulonephritis and 104 cases of other diseases.The differences between the primary morbidity and BMD were examined,and the P value was 0.109,indicating no significant differences between BMD and the primary morbidity?P>0.05?.In the dialysis group,the proportion of female patients in the group with abnormal bone mass was higher than that in the group with normal bone mass?P<0.05?,and the proportion of patients aged>60 in the group with abnormal bone mass was higher than that in the group with normal bone mass?P<0.05?,suggesting that women and older people are more prone to osteoporosis.Before dialysis,dialysis group blood hemoglobin,blood calcium,phosphorus,serum iPTH,body mass index?BMI?,age of dialysis and the correlation of bone mineral density value analysis,patients with MHD blood hemoglobin,blood calcium,phosphorus,there is no correlation between body mass index?BMI?and bone mineral density?P>0.05?,there are correlation between serum iPTH,age of dialysis and bone density?P<0.05?,and with the increase of iPTH,the increase of the age of dialysis,bone mineral density values gradually decline,the possibility of osteoporosis.Conclusions:1.Compared with healthy people,the incidence of osteoporosis and bone loss in MHD patients is significantly higher.2.Women and elderly patients are prone to osteoporosis.Hemoglobin,blood calcium,blood phosphorus,BMI and primary disease are not risk factors for osteoporosis in MHD patients,while serum iPTH and dialysis age may be risk factors for osteoporosis in MHD patients.3.The higher the serum iPTH,the longer the dialysis age,and the greater the possibility of osteoporosis in MHD patients.