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논문분류	춘계학술대회 초록집
제목	Effect of Metabolic Acidosis and Vitamin D Deficiency on Bone Mineral Density in Patients with Chronic Kidney Disease
저자	Mi Jung Lee1, Kyoung Sook Park1, Young Eun Kwon1, Seung Hyeok Han1, Tae-Hyun Yoo1, Curie Ahn2, Kyu Hun Choi1
출판정보	2015; 2015(1):
키워드	골밀도,대사성산증,비타민D결핍
초록	Background: Metabolic acidosis and vitamin D deficiency is an established risk factor for osteopenia or osteoporosis in general population. Although metabolic acidosis and vitamin D deficiency are prevalent in chronic kidney disease (CKD) patients, the association of metabolic acidosis and vitamin D deficiency with bone mineral density (BMD) has not been fully evaluated in these patients. Therefore, this study was aimed to assess the risk of abnormal BMD on metabolic acidosis and vitamin D deficiency in patients with CKD. Methods: We included 1,425 participants with CKD stage 1 to 5 who enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD) from April 2011 to December 2013. Metabolic acidosis was defined as serum bicarbonate <22 mEq/L, and vitamin D deficiency was defined as serum calcidiol (25-hydroxyvitamin D) <20 ng/mL. Subjects were categorized into two groups, normal or osteopenia group with the cutoff T-score of -1.0 at total hip and femur neck. Logistic regression analysis was used to assess the independent association of metabolic acidosis and vitamin D deficiency with BMD. Results: The mean age was 53.1 years, 940 (65.9%) patients were male. Metabolic acidosis was found in 1326 patients (93.1%), and vitamin D deficiency in 859 patients (60.3%). Osteopenia was diagnosed in 264 patients (18.5 %) by total hip and 444 (30.2%) patients by femur neck. Multivariate logistic regression analysis demonstrated that patients with both metabolic acidosis and vitamin D deficiency had increased risk of osteopenia of femur neck (odds ratio=1.017, 95% confidence interval=1.003 to 1.939, p=0.048). However, there was no significant association in total hip. Conclusion: Metabolic acidosis and vitamin D deficiency had significant association with decreased BMD in patients with CKD, suggesting that intervention of metabolic acidosis and vitamin D deficiency could be helpful in these patients.
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