If dialysis then osteoporosis?

During my last scheduled visit with my GP, he suggested due to my age and dialysis status it was prudent that I have a bone density test conducted which I did. You can view the result below:

As you may ascertain, the bottom line is that the results of my bone density test indicate that I indeed am experiencing Osteoporosis. This phenomenon is a lot like diabetes; in my case, you can’t see it or feel it, it’s just there for a doctor’s prognosis. So the question becomes, in the pickle that I am currently in with dialysis, what can be or should be done about it? And just what is this ailment that I have now been flagged with? It can’t cause my hair to fall out because that has already happened – like when I was but sixteen.

So the first thing let’s look at is the measurements used in flagging me with this fragility, and what does WHO have to do with it?

I asked Poe to provide insight in this area with the following results:

The criteria for osteoporosis diagnosis are primarily established by the World Health Organization (WHO) and are commonly referred to as the “WHO criteria.” The WHO criteria for osteoporosis are based on bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DXA) scans. The criteria are as follows:

Normal: A T-score of -1.0 or above indicates normal bone density. A T-score compares a person’s BMD to the average BMD of young, healthy adults of the same sex.

Osteopenia: Osteopenia refers to low bone mass, which is a precursor to osteoporosis. Osteopenia is diagnosed when the T-score is between -1.0 and -2.5.

Osteoporosis: Osteoporosis is diagnosed when the T-score is -2.5 or below. This indicates significantly low bone density and an increased risk of fractures.

It’s important to note that the WHO criteria are primarily focused on postmenopausal women and men aged 50 and older. For individuals under the age of 50, other criteria may be used, such as the Z-score, which compares the BMD to the average BMD of individuals of the same age, sex, and ethnic background.

Lastly, I queried Poe about the relationship between dialysis and osteoporosis with the following results:

Poe Assistant

Osteoporosis and dialysis are two separate medical conditions that can often coexist or be linked in certain individuals. Let’s discuss each condition individually and then explore their potential relationship.

1. Osteoporosis:
   Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fractures. It is a common condition, particularly among postmenopausal women, but it can affect both men and women of all ages.

The development of osteoporosis is influenced by several factors, including genetics, hormonal changes, lifestyle choices, and certain medical conditions or treatments. Risk factors for osteoporosis include advanced age, female gender, low body weight, sedentary lifestyle, smoking, excessive alcohol consumption, family history of osteoporosis, and the long-term use of certain medications like corticosteroids.

2. Dialysis:
   Dialysis is a medical procedure used to artificially replace some of the kidney’s functions in individuals with end-stage renal disease (ESRD) or severe kidney failure. ESRD occurs when the kidneys are no longer able to effectively filter waste products and excess fluid from the bloodstream. Dialysis helps in removing waste products, regulating electrolyte balance, and managing fluid levels.

Now, let’s explore the potential relationship between osteoporosis and dialysis:

Chronic kidney disease (CKD), which often leads to ESRD requiring dialysis, can be associated with an increased risk of osteoporosis. Several factors contribute to this increased risk, including hormonal imbalances, reduced vitamin D activation, impaired calcium-phosphate metabolism, and the use of certain medications like corticosteroids during dialysis treatment.

Moreover, individuals on long-term dialysis may experience mineral and bone disorders (MBD), which encompass a spectrum of bone-related abnormalities. MBD in dialysis patients is characterized by alterations in bone turnover, mineralization, and volume, leading to various bone disorders, including osteoporosis.

The management of osteoporosis in individuals undergoing dialysis involves a multidisciplinary approach. It may include optimizing dialysis treatment, ensuring an adequate intake of calcium and vitamin D, encouraging weight-bearing exercise, and, in some cases, prescribing medications to improve bone density.

It’s important to note that the relationship between osteoporosis and dialysis is complex, and not all individuals on dialysis will develop osteoporosis. However, if you or someone you know is undergoing dialysis and has concerns about osteoporosis, it is advisable to consult with a healthcare professional for an accurate assessment and appropriate management plan.

My GP recommended that I start on a regimen of OTC drugs Vitamin D3 and K2 along with Ca. My nephrologist vetoed calcium as my current dialysis labs indicate I’m doing OK in this area.

So what’s the bottom line? Seems that If dialysis, then Maybe/Perhaps Osteoporosis, and the link is casual but not inclusive. But it got me, didn’t it?