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ORIGINAL RESEARCH article

Front. Med.
Sec. Nephrology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1471418

Use of 3D-DXA in assessment of bone structure among subjects with chronic kidney disease

Provisionally accepted
Martin Kužma Martin Kužma 1*Zuzana Kužmová Zuzana Kužmová 1Ludovic Humbert Ludovic Humbert 2Mirella Lopez Picazo Mirella Lopez Picazo 2Roman Králik Roman Králik 1Jakub Falat Jakub Falat 1Juraj Smaha Juraj Smaha 1Peter Jackuliak Peter Jackuliak 1Zdenko Killinger Zdenko Killinger 1Juraj Payer Juraj Payer 1
  • 1 Comenius University, Bratislava, Slovakia
  • 2 Galgo Medical, Barcelona, Spain

The final, formatted version of the article will be published soon.

    Patients in later stages of the chronic kidney disease (CKD) has 2-14-fold increase in fracture risk. Bone Mineral Density (BMD) assessment is limited due to lack of possibility to measure trabecular and cortical bone characteristics and interference of aortic calcifications.Study objective: Assessment of trabecular bone score (TBS) and 3D-DXA in subjects across all CKD stages.Patients and methods: In total, 64 CKD (28 females/36 males; age 69.5 years) subjects were included. There were 9; 12; 8; 9; 11 and 15 subjects in stage G1, G2, G3a, G3b, G4 and G5 of CKD, respectively. BMD at lumbar spine(LS) and proximal femur, LS TBS were analyzed. Proximal femur parameters such as cortical and trabecular volumetric (v)BMD, cortical thickness (CTh) and surface (s)BMD at total hip (TH) and femoral neck (FN) were analyzed by 3D-Shaper software.Results: Comparison of earlier stages (G1-G3a) versus later CKD stages (G3b-G5) showed significant differences in CTx (386 vs.1053 ng/l); TH aBMD (0.991 vs. 0.859 g/cm2), cortical TH vBMD (831 vs 795 mg/cm3) and at FN (837 vs. 788 mg/cm3), TH cortical sBMD (170 mg/cm2) and TH Cth (2.03 vs 1.92 mm) (all p<0.05). Cross-sectional comparison between each CKD stage showed gradually decreasing LS BMD, TH cortical vBMD, sBMD (FN and TH) and TH Cth. Strong positive associations between GFR and cortical parameters (FN/TH vBMD and TH Cth) were observed (p<0.01).To conclude, advanced stages of CKD (G3b -G5) have lower cortical bone parameters.Most of the cortical parameters were associated with GFR, showing direct relationship of kidney function and bone.

    Keywords: Chronic Kidney Disease, bone quality, 3D-densitometry, Cortical bone, bone mineral density

    Received: 27 Jul 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Kužma, Kužmová, Humbert, Picazo, Králik, Falat, Smaha, Jackuliak, Killinger and Payer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Martin Kužma, Comenius University, Bratislava, Slovakia

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