CHANGES IN BONE-MINERAL CONTENT DURING LONG-TERM CAPD - INDICATION OFA SEX-DEPENDENT BONE-MINERAL LOSS

Change in bone mineral content (BMC) was evaluated in a longitudinal t rial comprising 12 women and 11 men with chronic renal disease treated with CAPD and 1-alpha-OH-D3 for 2 years. The patients served as their own controls. No patients were treated with steroids. Median age was 54 and 60 years for women and men respectively. No significant differe nce in 1-alpha-OH-D3 dosage or serum 1,25(OH)(2)D3 was found between t he genders in the study period. Bone mineral content at the distal rad ius deteriorated significantly in the females with a median decrease o f 12% over 2 years, i.e. approximately 6% per year (P < 0.001 and 95% confidence limits 8-20%). No significant change was noted in the males . There was no correlation between age and BMC change. Serum total alk aline phosphatase decreased nonsignificantly in both sexes. Total seru m calcium increased significantly (P < 0.05) and serum phosphate decre ased significantly (P < 0.05) in the women. Serum albumin and body wei ght decreased significantly in the males (P < 0.01 and P < 0.05) while no change was seen in the females. The demonstrated decrease in BMC i n the female patients of approximately 6% per year exceeds the commonl y observed loss of 1-2% per year in healthy women when measured with t he same technique. Tentatively, the severe mineral loss in the women c ould indicate a sex-hormone-related disturbance in bone metabolism of uraemic females.