RETROSPECTIVE STUDY ON THE USEFULNESS OF RADIUS AND LUMBAR BONE-DENSITY IN THE SEPARATION OF HEMODIALYSIS-PATIENTS WITH FRACTURES FROM THOSE WITHOUT FRACTURES

We measured bone mineral density (BMD) at the lumbar spine (LS-BMD), 1 /3 radius (1/3R-BMD), and ultradistal radius (UDR-BMD) in 59 men (4 wi th spine fractures and 4 with nonspine fractures) and 65 women (10 wit h spine fractures and 9 with nonspine fractures), all receiving mainte nance hemodialysis (HD), The BMD at each site expressed absolutely in g/cm(2) was significantly lower in women than in men (p = 0.0001), In men, the absolute and age-matched values of both 1/3R- and UDR-BMD wer e inversely and significantly correlated with the duration of HD, and with serum alkaline phosphatase and parathyroid hormone levels (p < 0. 05), whereas such relationships were obscure in women, On the other ha nd, the absolute values of BMD at each site in women but not in men we re inversely and significantly correlated with patient age (p < 0.001) , In both sexes, R-BMD was significantly lower in both the spine and n onspine fracture groups than in the nonfracture group (p < 0.05 and p < 0.01, respectively), whereas the only significant difference in LS-B MD was that it was lower in women with spine fractures than in women w ithout fractures, when expressed as its absolute value (p < 0.05), By receiver operating characteristic analyses, both the absolute and age- matched values of R-BMD were better than LS-BMD as a determinant of no nspine fracture histories, and were similar to absolute LS-BMD as a de terminant of spine fracture histories, We conclude that R-BMD is more valuable than LS-BMD for discriminating HD patients with all types of fractures from those without fractures. (C) 1996 by Elsevier Science I nc.