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Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life

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Abstract

Summary

Postmenopausal hemodialysis patients are at risk of complications related to renal mineral and bone disorder, and postmenopausal osteoporosis. In 112 postmenopausal hemodialysis patients, free estrogen index was positively correlated with bone mineral density (BMD) Z-score and the annual percent change of BMD in multiple regression analysis. Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life.

Introduction

Women on dialysis are not only at risk of developing mineral and bone disorder, but also suffer from postmenopausal osteoporosis. We assessed the effect of sex hormones on bone metabolism in postmenopausal hemodialysis patients.

Methods

We enrolled 112 postmenopausal hemodialysis patients with a mean age of 68.4 ± 10.4 years. We measured the serum levels of estradiol, testosterone, sex hormone-binding globulin (SHBG), and intact parathyroid hormone (intact-PTH), as well as bone metabolism parameters and radial bone mineral density (BMD). The free estrogen index (FEI) was calculated from the estradiol and SHBG values. After conventional dialysis was performed for 12 months, BMD was measured again and the annual percent change was calculated. Estradiol and SHBG were also measured in 25 postmenopausal women without chronic kidney disease.

Results

Estradiol levels were higher in the hemodialysis patients than in the postmenopausal women without chronic kidney disease. In patients with relatively normal bone turnover (intact-PTH: from 150 to 300 pg/ml), the FEI showed a positive correlation with the BMD Z-score. The annual percent change of BMD showed a positive correlation with the FEI according to multiple regression analysis.

Conclusions

Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life.

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Acknowledgments

This study was supported by Grants-in-Aid for kidney failure and hemodialysis research from the Japanese Association of Dialysis Physicians.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan

    N. Sugiya & N. Kohno

  2. Department of Advanced Nephrology, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi Minami-Ku, Hiroshima City, 734-8551, Japan

    A. Nakashima & N. Yorioka

  3. Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan

    A. Nakashima & J. Tanaka

  4. Department of Internal Medicine, Hakuai Clinic, Kure, Hiroshima, Japan

    N. Takasugi

  5. Department of Internal Medicine, Chuonaika Clinic, Kure, Hiroshima, Japan

    A. Kawai

  6. Department of Internal Medicine, Clear Yakeyama Clinic, Kure, Hiroshima, Japan

    K. Kiribayashi

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  1. N. Sugiya
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  2. A. Nakashima
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  3. N. Takasugi
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  4. A. Kawai
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  5. K. Kiribayashi
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  6. J. Tanaka
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  7. N. Kohno
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  8. N. Yorioka
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Corresponding author

Correspondence to A. Nakashima.

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Sugiya, N., Nakashima, A., Takasugi, N. et al. Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life. Osteoporos Int 22, 1573–1579 (2011). https://doi.org/10.1007/s00198-010-1350-y

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  • DOI: https://doi.org/10.1007/s00198-010-1350-y

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